New account

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Choose your username and password

Username

The password must have at least 6 characters, at least 1 digit(s), at least 1 lower case letter(s), at least 1 upper case letter(s), at least 1 non-alphanumeric character(s) such as as *, -, or #

Password

More details

Email address

Email (again)

First name (your first and last name will appear on the certificate)

Surname

City/town

Country

User Data. Your address will be used to ship your naloxone kits. All user data will be used to improve and refine naloxone training.

Gender (as per provincial health record)

Provincial Health Number

Federal Program Drug Coverage

Federal Program Eligibility Number

Street Number (this is where your naloxone kits will be shipped).

Street Name

City/Town

Province/Territory

Postal Code

How did you find out about our Naloxone training course?

Comments

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