Inscrivez-vous aux activités / Please register / Regístrate para participar

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Our physical and mental well-being activities, language training, and digital support are offered to both permanent and temporary residents. There are also spaces available for young people aged 18 and over.

First Name *

Last Name *

Phone Number *

Email *

Referred by: *

Select or enter the name of the organization or person who referred you.

Description - Si vous avez choisi "autre" précédemment, mentionner qui vous a référé.e *

Gender: *

F
M
Other

Native country: *

Status: *

Permanent resident
Protected person
Futur résident permanent approuvé
Temporal resident
Ukrainian (with CUAET authorization)
Foreign nationals affected by the crisis in Gaza
Other

If other, please specify

Preferred language of communication

French
English

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Age *

18-35
36-49
50-64
65+

In which official language would you prefer to be served? *

French
English

In which form of activities would you prefer to be served? *

Present in person
Online

Please note that some activities require your presence in person

Navigation Santé à Ottawa , voudriez-vous: *

Connaître et avoir l'Information sur le système de santé provincial en général
Trouver un médecin de famille?
Demander une assurance santé?
Accompagnement pour réservez des rendez-vous médicaux
Comprendre les rôles des professionnels de santé
Connaître les hopitaux et les cliniques sans rendez-vous qui peuvent vous servir?
Other

Si autre, préciser

Avez-vous un médecin de famille? *

Oui/Yes
Non/No

Cochez d'autres services et activités auxquels vous souhaitez participer *

Matching activities in groups
Discovery of Canadian history and culture
French converstion circles
digital support
Short-term group and individual counseling
Connecting you with our partners
Youth's Voice - Various Activities for Young People
Other? If other discribe it in the " Other informations"

Would you like to be contacted for other services offered by CICAN? *

Other information:

By filling out this form, you agree to share your data with us. All data collected will be used only for the purpose of this booking and will not be shared with any third party unless you explicitly authorize it.

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