2025 Council Candidate Profile Form - College of Physicians & Surgeons of Alberta

Council candidate profile

Congratulations! Thank you for putting your name forward and putting so much time into the Council election process. We truly appreciate your participation and look forward to receiving your candidate profiles.

Please take some time to complete your candidate profile through the form below. When answering your questions, keep in mind that what you share will be used to create the candidate profile that will be shown to CPSA regulated members during the voting period. The information presented will help inform voter decision-making. In the interest of presenting valuable information as concisely as possible, aim to keep your answers informative but brief.

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Name*
Given name(s) Last
Credentials
Practice discipline*
Practice location*
Pronouns
What are some highlights from your professional background and experience?*
What is your reason for running?*
CPSA Council has identified 11 key competencies and attributes for Councillors.
Which competency or attribute do you feel you most represent? Provide a brief description of why.*
CPSA’s mandate focuses on protecting and serving the public. How would you contribute to this as a Councillor?*
What else would you like your colleagues to know about you?
Photo
Need guidance on taking a photo for your profile? Review our candidate photo guide!

While attaching a photo is not mandatory, we strongly encourage including a photo with your application since voters may be influenced by the exclusion of a face behind a profile.
Attach a high-resolution, photo (headshot only)
Please do not password protect your files.
Accepted file types: jpg, png, jpeg, Max. file size: 5 MB.
Signature
Checking this box will act as your signature:*
I confirm the above information is true and accurate
Date (should be typed in the format mm/dd/yyyy, as in 03/15/2023)*
MM slash DD slash YYYY

Council candidate profile

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