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Physician Leadership Network Registration

Interested physicians, please complete the form below to register for the provincial Physician Leadership Network. 


For more information about how the network can benefit you and your practice, please contact the Physician Leadership Network.

 

REGISTRATION FORM
Please provide the name of your clinic or organization.
Please select the role category that most closely matches your role.
Zone





How did you hear about us?






Your PCN has expressed interest in knowing who is participating in the Network. May we share your name with your PCN?


By submitting this form you are registering for the Physician Leadership Network and will receive relevant communications and invitations to all future Physician Leadership Network sessions.

Note: Personal information gathered by the AMA is used in accordance with the terms of the AMA Privacy Commitment Statement, available on the association’s website (www.albertadoctors.org) or by calling the AMA at 1-800-272-9680.

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Please note: If you are already a member of an existing Network, and you would like to add to your existing membership, proceed by submitting this form.  We will add the new registration and will not alter any existing Network membership. 

If you would like to be removed from any of the networks, or have any questions, please email Networks@albertadoctors.org.