dirinfo

CANADIAN PHYSICIAN COACHES NETWORK

Home
Find a Physician Coach
Our Board
Members only
Contact
Events
About CPCN

CPCN Directory Information Input Form
By joining CPCN I understand that members may be mentioned, tagged or have their practice spotlighted from time to time on social media as part of the coaching community. If I do not want this exposure, I will inform the Administration on joining.

* Indicates required field

Last Name *

First Name *

Email *

Languages in which coaching is provided *

Non coaching credentials, degrees or fellowships *

City *

Province *

Coaching Certification or Training *

Areas of Coaching Interest (select all that apply) *

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) *

Website Resume

If you have a website, please provide the full url, including http:// or https:// *

Personal Statement. Do not use this as bio; rather use it to make a statement that provides insight into your coaching approach *

Do you have any restrictions on clients that you accept? If not, enter "All" *

Photo. Please 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 *

Max file size: 20MB

If you chose resume rather than website for clients to obtain more information about you, please upload it here *

Max file size: 20MB

Captcha *

I am not a robot

Submit

admin@coach4md.org

• career development • leadership • managing teams• professionalism • coping with conflict • finding wellness and joy • preventing or escaping physician burnout • phasing to retirement • anything where you need to leave your comfort zone

Home
Find a Physician Coach
Our Board
Members only
Contact
Events
About CPCN

CPCN Directory Information Input FormBy joining CPCN I understand that members may be mentioned, tagged or have their practice spotlighted from time to time on social media as part of the coaching community. If I do not want this exposure, I will inform the Administration on joining.​

• career development • leadership • managing teams• professionalism • coping with conflict • finding wellness and joy • preventing or escaping physician burnout • phasing to retirement • anything where you need to leave your comfort zone

CPCN Directory Information Input Form
By joining CPCN I understand that members may be mentioned, tagged or have their practice spotlighted from time to time on social media as part of the coaching community. If I do not want this exposure, I will inform the Administration on joining.