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Virtual Consultation Request for Health Care Providers

Thank you for your interest in virtual consultative services to support strengthening capacity with healthcare professionals who provide end-of-life care with Indigenous communities. This program is a collaboration between the SE First Nations, Inuit, and Métis Program and Journey Home Hospice (a program of the Saint Elizabeth Foundation). All consultations are offered at no cost to users. Please complete the following form to request an individual virtual consultation.

Indigenous Consultation Request

Name *

Name

First

First

Last

Last

Email Address *

Phone *

Organization Name *

Position *

Type of Consultation (check all that apply): *

Peer to Peer Support from Registered Health Care Providers

Guidance for Symptom and Withdrawal Management

Policy and Procedures

Harm Reduction Practices

Operational Support for Hospice-Like Spaces

Wellness Programming

Spiritual Care and Bereavement Support Services

Navigating Social Services for Funded Funeral Services

Knowledge Sharing

Other (please do not include any personal health information):Other (please do not include any personal health information):

How would you like to receive communications from our team? *

Please note that there will be a 72 hour turnaround time for consultations. If you require an urgent response please check the box below and we will do our best to connect with you sooner.

Urgent Request

If you are human, leave this field blank.

Thank you for your interest in Saint Elizabeth Foundation Programs

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Charitable registration number: 88472-6753-RR0001

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