Peer Learner Application

Interested in being a Peer Learner as part of the Practising Well program? Provide us with your information below and we'll match you with a Peer Guide.

A Peer Learner is a family physician who has identified a need for support in the areas of mental health, substance use disorders and/or chronic pain.

If you haven't already done so, please read the Peer Learner role description and/or contact us with your questions.

Let's get started...

I have read and understand the Peer Learner role description. *

I understand that Practising Well is designed to provide educational support to family physicians. It is not a clinical consultation support for specific patients *

Personal Information

Your Personal Information - Please provide your contact information below.

First Name *

Last Name *

Email *

Text Box

OCFP programs strive to represent the full range of our membership, including all practice types and regions of the province. Please tell us your location and your practice type.

Practice Location

Your Practice Location - Please select all that apply.

West Region (ESC, SW, WW, HNHB)

Central Region (MH, CW, C, NSM)

Toronto Central (TC)

East Region (CE, SE, CH)

North Region (NE, NW)

Direct Credit Entry

Mainpro+ Direct Credit Entry

I wish to have my earned credit(s) directly into my Mainpro+ account.

Yes

If you selected yes to the question above, provide your CFPC number and your earned credit(s) will be directly entered into your Mainpro+ account. Your CFPC number must start with a "6".

Peer Guide Matching

Peer Learners will identify one or more learning goals based on their identified areas of focus and receive a combination of 1:1 and group support to achieve their goals.

Areas of Focus

Which area(s) of focus interest you?

Mental Health

Substance Use Disorders

Chronic Pain

Other

If other, please specify:

Peer Guide Matching

Peer Learner-Peer Guide Matching

Are you already working with a Peer Guide (mentor)? If so, please provide their name below.

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