Home Sitemap Contact Us Communications The CJRM About the SRPC Our Resources Continuing Medical Education Search:   Overview Student Electives Catalogue SRPC Student Committee Rural Experiences Access Program Preceptors Submit Preceptor Information   Our Resources For StudentsSubmit Preceptor Information Name: Are you : <Select> Rural GP GP-anest GP-OB GP-surgeon Specialist Other Address: City/Town: Province: <Select> Alberta British Columbia Manitoba New Brunswick Newfoundland Nova Scotia Nunavut Ontario Québec Saskatchewan Yukon Territory Postal Code: Region: <Select> Other Labrador Newfoundland Nova Scotia PEI New Brunswick Québec Outaouais-Abitibi-Témiscamingue Québec Côte-Nord, Nord-du-Québec Québec Laval, Lanaudière, Laurentides Québec Saguenay Lac St-Jean, Mauricie Bois-Francs Québec South of St. Laurence R Ontario North Eastern Ontario North Western Ontario Central Ontario South Eastern Ontario South Western Manitoba Saskatchewan Alberta Northern Alberta Southern BC Lower Mainland BC Vancouver & other Islands BC Central BC Northern Yukon Northwest Territory Nunavut Years in Practice: Contact (yourself or...): Office Phone: ( ) - Home Phone: ( ) - Fax : ( ) - E-mail: Types of Experiences Offered: Office Inpatients Obstetrics Emergency Anesthetics Assisting Is there a hospital? Yes No If 'yes' to above:   Number of full time FP/GP on staff: Number of Local Specialists: Has the community hosted students? Yes: No: Please tell us about your community and hospital leisure activities, suggestions for travel, accommodations, food:   SMALL PRINT: By submitting the information you grant us permission to edit, post to the web, or not. Posting depends on volunteer labor.   © Copyright 2009 The Society of Rural Physicians of Canada All Rights Reserved. P. O. Box 893 | 269 Main Street | Shawville, QC | J0X 2Y0 Toll Free: 1-877-276-1949 | Fax: (819) 647-2485