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Role Observation Experience
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394 * First Name:
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395 * Last Name:
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396 * Your Profession:
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397 * Observation Profession:
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398 Preceptor Contact Info (e.g. email, phone #):
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399 * Student Contact Info (e.g. email, phone #):
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400 * Name of person inputting this information:
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401 * Select the debrief date you wish to attend (select one):
   Wed May 22/19, 3:00-4:00 pm
 Thurs June 20/19, 3:00-4:00 pm
 Thurs July 18/19, 3:00-4:00 pm
 Thurs Aug 8/19, 3:00-4:00 pm
 Thurs Aug 15/19, 2:00-3:00 pm (limited to Summer Care Providers)
 Thurs Sept 19/19, 3:00-4:00 pm

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403 Note: the debrief sessions will be held in the Southlake Village, Level 5, in the Professional Practice corridor at the end of the hall in the atrium.
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Southlake Regional Health Centre
596 Davis Drive, Newmarket, Ontario   L3Y 2P9
Tel: 905-895-4521   |   TTY: 905-952-3062
Copyright © 2012 Southlake Regional Health Centre
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