CAPS Registration

From CAPS CPCA Forum

Each submitted form is reviewed by an administrator. You will be contacted by email with your login details when your submission has been approved. You may need to check your spam/junk mail for the registration email. If you do not get an email after a few business days, please contact cart.assist@ubc.ca.

First Name:*
Last Name:*
Email:*
Language:*
Postal Code:*
City:*
Province:*
Role:*
Specify Role:
Clinic/Hospital Name:
Specialty:
Specify Specialty:
Years in Practice:
Prior Provision of
Abortion Services:
Yes
No
This community provides Mifepristone trained physicians with a way
to locate the nearest trained pharmacist.
Do you agree to disclose the name and location of your pharmacy for this map?
I agree    I disagree    
Pharmacy Name:
Pharmacy Address:
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Terms and Conditions
*must scroll through consent form
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Consent Form for CAPS Website

How we protect and use your data

This website is part of the Mifepristone Implementation Research in Canada study (The CART-Mife Study) which aims to identify and address the facilitators and barriers for successful initiation and ongoing provision of medical abortion services using mifepristone.

We will collect data including: your demographic information; posts on challenges, barriers and facilitators; responses to a weekly 1-question poll; and participant usage statistics. We will also collect your contact information to inform you of future opportunities to participate in research. You will be assigned a unique study number and your personal information will be kept confidential. Your name and identifying information will not be included anywhere in the analysis or report for this study. Member IP addresses and identifiers will not be collected for research purposes. Computer files will be password-protected on a password-protected computer and stored securely on a UBC server.

We do not believe that participating in this study represents any risk to you. Participants will contribute to knowledge of the barriers and challenges faced when providing medical abortion care in Canada. The main results of our study will be presented to health system and policy leaders to improve policies and systems that support your provision of safe, accessible medical abortion care. We will also report aggregate findings (with no personal identifiers) in academic journals and conferences.

Your participation is optional and you may choose to withdraw from the study at any time. For more information, contact the Research Participant Complaint Line in the University of British Columbia Office of Research Ethics (e) RSIL@ors.ubc.ca (t) 604-822-8598 or 1-877-822-8598. Principal Investigator: Dr. Wendy Norman, Associate Professor, Dept. of Family Practice, Faculty of Medicine, UBC (e) wendy.norman@ubc.ca (t) 604-875-2424 x4880

I agree to have my demographic information used for research purposes.
I agree to have my posts on challenges, barriers and facilitators used for research purposes.
I have read and agree to the terms in the consent form