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CPCN Directory Information Input Form
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Indicates required field
Last Name
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First Name
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Email
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Languages in which coaching is provided
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Non coaching credentials, degrees or fellowships
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City
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Province
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NL
PE
NS
NB
QC
ON
MB
SK
AB
BC
NU
NT
YT
Coaching Certification or Training
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Areas of Coaching Interest (select all that apply)
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Worklife balance/wellness/burnout
Career development and transitions
Conflict
Effective communication
Female Physicians
Leadership development and practice
Professionalism
Surgical/technical coaching
Team Coaching
Substance use/recovery
If clients wish to know more about you do use a website or do you wish to upload a resume? (Please pick one - if you wish to upload a resume you will be able to do so at the end of this form)
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Website
Resume
If you have a website, please provide the full url, including http:// or https://
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Personal Statement. Do not use this as bio; rather use it to make a statement that provides insight into your coaching approach
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Do you have any restrictions on clients that you accept? If not, enter "All"
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Photo. Pleaser provide a head shot laid out similarly to a passport photo. png, jpeg or tiff format only. File size between 200kb and 2 Mb preferred
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Max file size: 20MB
If you chose resume rather than website for clients to obtain more information about you, please upload it here
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Max file size: 20MB
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Home
Our Member Coaches
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Members only
Contact
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About CPCN