MS 101 Registration
MS 101
is a 75-minute, interactive virtual session meant to inform, aid and support individuals who are starting their MS Journey. These sessions are open to people living with MS and members of their support network; and will provide introductory information about multiple sclerosis and will highlight some of MS Canada’s supports for people affected by multiple sclerosis. We will provide a safe and open forum for individuals to ask questions and engage with others who have also been recently diagnosed, while connecting to MS knowledge experts. It is our hope individuals will leave with increased awareness about MS, the tools to navigate their MS journey, plus confidence when making decisions about their health and wellness.
First name:
Last name:
Email:
Phone number:
Province/Territory:
Please select...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code:
Age:
Please select...
18-24
25-34
35-44
45-54
55-64
65+
I live with
/ identify as
:
Please select...
Clinically Isolated Syndrome
Relapsing Remitting MS
Primary Progressive MS
Secondary Progressive MS
Allied Disease (e.g., NMOSD, TM, ADEM)
Unknown/not sure
I am a caregiver for a person who lives with MS/Allied Disease
MS Staff
Health Care professional
Prefer not to disclose
Other (specify)
Other (specify):
How did you hear about this event:
Please select...
MS Canada website
MS Knowledge Network/MS Navigators
MS Canada staff/volunteer
MS Canada email/e-news
MS Canada social media pages
MS Canada event (MS Walk, peer support group, etc.)
Advertising (radio, social media, etc.)
MS Clinic/healthcare practitioner
Friend/acquaintance/family member
Other (specify)
Other (specify):
Please choose which session of MS 101 you are interested in attending?
Please select...
April 18, 2023, at 8:30pm EST
May 16, 2023, at 6:00pm EST
June 20, 2023, at 8:30pm EST
July 18, 2023, at 6:00pm EST
September 19, 2023, at 8:30pm EST
October 17, 2023, at 6:00pm EST
November 21, 2023, at 8:30 EST
Do you have any questions for the presenters?
Please be aware we may not be able to address all questions during the presentation
Other than notifications about this education program, would you like to receive emails from MS Canada?
Yes
No
Waiver
MS Canada collects personal information for the purpose of communicating information to you about MS Canada and its programs, events and volunteer opportunities, and to compile anonymous statistical information. By completing this form, you acknowledge and consent to the collection and use by MS Canada of your personal information for these purposes. If you have any questions about your personal information, or MS Canada’s privacy policy please contact our Privacy Officer at
priv@mscanada.ca
.
I understand and agree to the above
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