SP Profile Form - Regina - USask Health Sciences

Confirmation will be sent to this address.

Home

Cell

Work

Street address

Street Address

City

Province / State

Postal Code/ZIP Code/Rural Route

Country

Demographic Information

We ask these particular demographic questions for purposes of matching SPs to specific roles. Your information is kept confidential.

Please indicate feet-inches or centimetres

Please indicate pounds or kilograms

In your own words, how would you describe your race or ethnicity?

Any ongoing physical or mental health conditions that you feel comfortable disclosing

Including surgical and non-surgical; visible and palpable

Yes

Maybe

Using your body to teach proper technique and communication for well-female (breast, pelvic) and well-male (pelvic, rectal) physical exams

Yes

Please indicate yes for full-time, part-time or casual employment on-campus

Medicine, Nursing, Dentistry, Physical Therapy, Pharmacy and Nutrition, Veterinary Medicine