Workshop Registration

Parenting a Child with ADHD - Virtual Workshop - October 21 @ 5:30 pm

by Children's Mental Health Services

Child/Youth Information

First name

Last name

Date of birth

Gender

Pronouns

Preferred spoken language

Primary phone

Email

Notifications will be sent to this address

Confirm email

Does not have an email address

Address

Apartment/suite, P.O Box, etc.

City

Province

Postal code

Parent/Guardian Information

First name

Last name

Primary phone

Extension

Email

Notifications will be sent to this address

Confirm email

Does not have an email address

Relationship to child/youth

Is there a second parent/guardian?

Yes

No

Does the child/youth have a family doctor or nurse practitioner?

Yes

No

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Parenting a Child with ADHD - Virtual Workshop - October 21 @ 5:30 pm

Child/Youth Information

Parent/Guardian Information

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