Clinical Detoxification CECDC Registration

Name*
Prefix First Last
Phone*
Email*
Address*
Street Address City Province Postal Code

If you are outside Canada, choose the blank space above Alberta in the Province dropdown list to continue with your registration.
Name of country (if outside of Canada)
Are you an IHN Graduate?*
- Yes
- No
If yes, please indicate year
Where did you hear about IHN’s Continuing Education Courses?
Are you an IHN current student?*
- Yes
- No
Do you require the suggested materials for this course?*
- Yes
- No

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