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Standards support intake form
Standards support intake form
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Standards support intake form
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About Standards Support»
Trouble-shooting
If you encounter an error when you submit this form, please email your support request to
sgfeedback@bccnm.ca
.
The asterisk
*
indicates a required field
Contact information
First name
*
First name is required.
Last name
*
Last name is required.
Email
*
Email is required.
Your email address appears invalid.
Phone number
Registration number, if applicable
Employment/practice setting
Organization
Tell us who you are
Applicant
BCCNM Registrant
Employer
Member of the public
Student
Other health care provider
Other – not listed
Your practice setting
*
Association/government
Business/industry/occupational health
Community health agency and health centre
Educational institution
Home care agency
Hospital (general, maternal, pediatric, psychiatric)
Long term care/nursing home
Mental health
Nursing station/outpost nursing clinic
Physician's office/family practice unit
Private nursing agency/private duty
Public health department or unit
Rehabilitation/convalescent care
Self employed/private practice
Other
Your practice setting is required.
Position
*
Chief nursing officer/chief executive officer
Clinical specialist
Consultant
Director, assistant, associate
Instructor/professor/educator
Manager/assistant manager/supervisor
Non-registrant including public
Nurse practitioner
Nurse practitioner student
Researcher
Staff nurse/home care/community nurse
Student nurse
Other
Position is required.
Your consultation request
Which designation(s) does your inquiry apply to? Check all that apply
Certified practice nurse
Licensed practical nurse
Nurse practitioner
Registered nurse
Registered psychiatric nurse
Registered midwife
Student
Employed student registrant
What is your standards-related question?
*
Provide only details that are necessary to understand your standards-related question. Do not provide personal details about yourself, clients or others.
Your standards-related question is required.
Your standards-related question can only contain alphanumeric characters and the following single characters .,-?!/':()@
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