This form is used to register students, staff, faculty and researchers for the Online PHIA Training Modules. Complete the form and click the “Submit Registration” button to send your registration.
Once you have submitted your registration, you will receive a link to the presentation modules. Follow the instructions in the module to complete the training.
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 | 1) Enter your full name (First and Last) |
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| 2) Enter your University of Manitoba email address here. If you don't have a valid UM email address, please enter your primary email address. A copy of your validated Pledge of Confidentiality will be sent to this email address. |
| Note: A copy of this form will be emailed to this address upon completion.
Send me this email as HTML instead of plain text.
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| 3) Enter your mailing address.You can skip this step if you have already provided a valid email address (question #2). A copy of your validated Pledge of Confidentiality will be mailed to this address only if a valid email address has not been provided. |
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| 4) Date |
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| 5) Position |
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| 6) If you are doing research, please enter your REB Protocol Number |
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| 7) Faculty, Unit or Organization |
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| 8) Training Module Required
If you are involved in a research study that is collecting personal health information, or you are associated with a health-related unit, such as one of the following units/faculties/departments/offices listed below, you must select Training Module A. Accessibility Services
Athletic Therapy Centre
Biosystems Engineering
Campus Dental Centre
Dentistry and Dental Hygiene
Elizabeth Hill Counseling Centre
Human Ecology
Human Rights and Equity Services
Inner-City Social Work Program
Kinesiology and Recreation Management
Manitoba Centre for Health Policy
Manitoba Institute for Child Health
Medicine (all departments, programs and offices)
Nursing
Occupational Therapy
Pharmacy (faculty of)
Pharmacy (University Centre)
Physical Therapy
Physician Assistant Studies
Psychological Services Centre
Psychology
Respiratory Therapy
Social Work
Student Advocacy
Student Counseling and Career Services
University Health Services
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| 9) What prompted you to register for the Online PHIA training? |
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