Provincial Mental Health and Substance Use ECHO Registration Form
Thank you for your interest in the Provincial Mental Health and Substance Use ECHO, hosted by BC Mental Health and Substance Use Services (BCMHSUS). As part of your registration we would like to ask you confidential questions to better understand and serve ECHO participants.
Participation in ECHO is voluntary. If you complete this form, you are consenting (agreeing) to participate. Please note that questions with an asterisk (*) must be completed in order to register. The information you share in the registration form is confidential. It will be accessed by the BCMHSUS ECHO team/technical support staff, and some information, limited to name, email address, and organization affiliation will also be shared with the University of New Mexico’s Health Sciences Centre ECHO Institute, the creators of Project ECHO, located in New Mexico, USA. These questions are shared to support the growth of the ECHO model and will be used for research, communications, quality improvement, and decision-making.
Additionally, your email address will be shared with Howspace, an online learning platform which will house ECHO session materials and resources. Your email will be used to create a unique link through which you will access Howspace. Howspace will never share or disclose your information with third parties.
We are asking you to share personal information including your email address, geographic location, personal views/opinions, gender (optional), and ethnicity (optional). Please use your business contact information if possible. Any reporting on the information you share in this form will be anonymized.
Your personal information is protected by the B.C. Freedom of Information and Protection of Privacy Act (FIPPA). Your information will be collected in accordance with section 26 (c) and (e) of FIPPA.
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