Please complete the form below to stay up to date with HNHB IPAC Hub communications.
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Name:
Email:
Comment:
First and Last Name
*
First and last name
Position/Title
*
What do you do at your organization
Organization
*
Where do you work
Organization Type
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Adult Developmental/Intervenor Services Congregate Residential Programs
Assisted Living
Child and Youth Mental Health Congregate Care Setting
Children's Residence
Foster Home
Group Home
Home for Special Care
Hospice
Indigenous Healing and Wellness Strategy Residential Programs
Lodging Home
Long Term Care
Mental Health and Addictions Adult Congregate Living Settings
Public Health
Rehabilitation
Residential Care Facility
Respite Program
Retirement Home
Shelter
Supportive Housing
Transitional Housing
Violence Against Women Shelters/Residential Programs
Youth Justice Facilities and Open and Secure Custody Settings
Other
Unknown
Type of congregate setting
Satellite Hub
*
Hamilton
Niagara
Haldimand-Norfolk
Brant
Other
Satellite hub that your organization falls under.
Address
*
Street address
City
*
City
Province
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Province
Postal Code
*
Postal Code
Phone Number
*
(
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-
Phone number
Email Address
*
Email address
Satellite Hubs
Satellite Hubs
Hub Leads
Hub Leads
PHO
PHO
