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Apply for the Medical Assistance in Dying (MAiD) Public Webpage Review

Thank you for your interest in participating on this project. We have a some questions for you to ensure that the opportunity is a good fit for you. Please click the 'submit' button to complete your application and a team member will connect with you in 1 week. 

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4.  

Select the following statements that apply to you:

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5.  

How would you like to provide feedback to the public webpage?

* required
6.  

If you selected an interview, when are you most likely to be available (please check all that apply):