Researcher form – patient partner match

If you are looking for French-speaking patient partners to join your research team, please provide the following information. Please note that this information will be shared with potential patients for matching purposes, i.e. to find the patient who best meets your selection criteria. We will send you the patient’s name and contact information only when the patient gives us consent.



    Please provide the principal investigator’s contact information:









    (Note that the end date does not represent the end date of the funding, but rather the end date of the knowledge translation activities that require the support of patient partners)






    Please indicate the desired characteristics of the ideal patient partner (check all that apply)