Register Overview Create an account to register Healthcare providers and people affected by diabetes Non Mental Health Provider "*" indicates required fields Name* First Last Country* ProvincePlease select an optionAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonLanguage*Please select an optionEnglishFrenchEmail Address* Enter Email Confirm Email Health Care Provider Type (Optional)Please select an optionGP/family physicianNurseEndocrinologistDiabetes educatorDietitianCommunity workerPharmacistOther allied health professional (please describe)Other Health Care Provider Connection to diabetes (optional)Please select an optionParentPerson living with diabetesFamily member of person living with diabetesCaregiver of someone living with diabetesStudentOtherOther connection to diabetes If you are a Mental Health Provider please Click Here How did you hear about us? Please select all that apply.* Social media Friend/colleague JDRF website JDRF newsletter/e-mail communication, or staff member Diabetes Canada A different diabetes organization A mental health organization Do not know Other (Please describe) Other description Password* Enter Password Confirm Password Note!These will be your login credentialsBy registering I consent to receive electronic messages related to the Mental Health + Diabetes Training Program and Directory from JDRF Canada. Your information will not be shared and you will always have the option to unsubscribe. More information on JDRF’s privacy policy can be found at jdrf.ca.* I consent By registering I consent to receive electronic messages related to the Mental Health + Diabetes Training Program and Directory from JDRF Canada. Your information will not be shared and you will always have the option to unsubscribe. More information on JDRF’s privacy policy can be found at jdrf.ca.Consent English* I agree to the Terms & Conditions and Privacy Statement.*EmailThis field is for validation purposes and should be left unchanged. Δ Already have an account? Login
