Membership fees are $25 annually. You do not need to register if you attend the May 27, 2006 conference.
Contact Information:
First Name: Last Name:
Address: City: Province:
Phone Number: Email Address:
Member Profile:
Choose what category best describes you:
Alt Medicine Citizen Chiropractor Dentist / Denturist Dietician Doctor Educator Health Food Store Hearing Centre Massage Clinic Nurse Occupational Therapist Optometry Orthtics Pharmacy Physical Therapy Politician Psyschologist/ Counsellor Other
How did you hear about us?
Friend Advertisment Newspaper Article Television Internet Search Other
Type of Membership:
Regular Associate - medical professionals with gov't wages
Interest Level (click all the apply):
I would like more information about the society
I would like to help CQH advertise upcoming events and causes
I would like to volunteer
What health issues are of a particular interest to you?
Benefits of Membership