Preferred Contact Method
    Home PhoneWork PhoneCell PhoneEmail

    Gender:
    MaleFemaleOther

    Age Category:
    Under 1818-2425-3940-5455-7071+

    What languages do you speak?
    EnglishFrenchOther

    Diversity is important to us. Are you a member of either of these groups?
    IndigenousVisible minorityPerson with a disability

    What is your primary employment status?
    Employed Full-TimeEmployed Part-TimeRetiredCaregiverStudentUnemployed

    What is your primary employment status?
    NewspaperRadioManitoba.caBrochureWord of mouthNorthernhealthregion.caOther