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Please Continue to Review Process

Registrant Information

* Fields marked with an asterisk are required.

Organization Information

Personalized Learning Program Details

*please allow 6 weeks prior to start date for application to be considered

Program Type

Program Type *Required

Fees listed are application fees. Program fee will be discussed upon application approval

Are learners part of an interprofessional team? *Required
Preferred Number of Sessions *Required
Student ID or letter of enrollment *Required


If you are currently enrolled in an academic institution, please provide proof of current registration.

Additional sessions can be purchased at a later date.

Have you completed a PLP session with UHN before? *Required

Personalized Learning Program Objectives

Upload Current Resume or Curriculum Vitae *Required

Upload Letter of Reference

Reference Letter

Additional Requirements

UHN Confidentiality Agreement 2016 *Required
Proof of completion of Privacy eLearning Module (screen shot or photo of the attestation form) *Required
Health Records

Immunization Requirements for:

  • Measles (Documentation of 2 doses of MMR vaccination OR Laboratory evidence of immunity)
  • Mumps (Documentation of 2 doses of MMR vaccination OR Laboratory evidence of immunity)
  • Rubella (Documentation of 2 doses of MMR vaccination OR Laboratory evidence of immunity)
  • Tetanus / Diphtheria / Pertussis (Every 10 Yrs.)
  • Influenza (every Winter/Fall) (recommended not mandatory)
  • Hepatitis B - Proof of immunity
  • Varicella - Laboratory evidence of immunity OR documentation of 2 doses of Varicella vaccination
  • TB: Mantoux (TB) Skin test status
  • A 2-step TB skin test (TST) completed within 28 days of one another, at any time OR TWO separate 1-step TB skin tests (TST) if both completed within the last 12 months
  • If any historical TST is positive, documentation of a CHEST X-RAY performed after the positive TST is required

Consent *Required
Terms and Conditions *Required

APPLICATION FEES

All fees are in Canadian dollars

In-person $150
Virtual $50
Workshop/Group $100

Visa or MasterCard accepted

FOR MORE INFORMATION

Please contact UHNice@uhn.ca