Attestation form

First Name*
Last Name*
Email (due to technical difficulties, we invite you to use an email address other than Gmail)*
Submission Date*
Please select the modules you have completed*
- Consent and confidentiality
- Communicating with adolescents
- Indigenous health
- Mental health
- Complexities of care of the elderly
- Communication skills module
- Professional challenges
- Compassionate virtual care
Confirmation*
- I attest to having completed the modules indicated above

Medical Council of Canada

1021 Thomas Spratt Place
Ottawa, ON Canada, K1G 5L5

T : 1-613-521-6012
F : 1-613-248-5234
E : [email protected]

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