Join - Individual Beneficiary

Multipage

1Practice Details
2Contact Info
3Acceptance of Terms
4Payment
5Confirmation

Practice Details

Order
Employment Information
If your employer withholds income tax and other at source deductions, you are probably an employee.
If your employer does not withhold income tax and other source deductions or if you provide nursing services as the owner of a professional corporation or other business entity, you are likely an independent contractor.
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If your employer withholds income tax and other at source deductions, you are probably an employee.
If your employer does not withhold income tax and other source deductions or if you provide nursing services as the owner of a professional corporation or other business entity, you are likely an independent contractor.
$

Contact Info

Preferred language for your account.

Acceptance of Terms

Professional Liability Protection

Supplementary Protection

The CNPS now offers an option to register for Supplementary Protection which includes assistance with College complaints (regulatory matters) as an additional service. You may learn more at this page: Supplementary Protection. Please note, supplementary protection period will match your professional liability protection period selected above.

Signature

Acceptance of terms

I hereby certify that the statements and information in this application form are true and correct to the best of my knowledge and belief.

I understand that the Canadian Nurses Protective Society (CNPS) may verify any of the information provided on this form. By signing this form, I authorize the CNPS to investigate all statements of information contained in it. I understand and agree that any misrepresentation, falsification or material omission of information on this form may result in denial or revocation of my beneficiary status with the CNPS.

I understand that my eligibility for CNPS Core Services (and, if I applied for it, Supplementary Protection) will be conditional upon being a CNPS beneficiary and having a valid licence or registration to practise nursing at the time of the events giving rise to the inquiry, claim or legal proceeding.

If I applied for Supplementary Protection, I understand that the CNPS will share my personal information, including my name, address and CNPS beneficiary identifier with a third-party insurer for the purpose of coverage for disciplinary or fitness-to-practise proceedings. By signing this form, I consent to CNPS sharing my personal information with a third-party insurer for this purpose. I understand that if my application for CNPS Supplementary Protection is accepted, I am generally not eligible for assistance with complaints, disciplinary hearings or fitness-to-practise hearings that have been initiated or should have been anticipated at the date of this application.

I understand that professional liability protection is required as a condition for practice in most Canadian provinces and territories. By submitting this application, I authorize the CNPS to confirm to my nursing regulatory body and to my employer or institution where I practise or seek to practise nursing that I am a CNPS beneficiary and eligible for CNPS professional liability protection.

I have read the excerpts of the CNPS Bylaws related to the provision of assistance and understand my obligation to report any threat, claim, complaint, legal proceeding or adverse event related to my nursing practice to the CNPS at the earliest opportunity and collaborate with the CNPS in all instances where assistance is granted.

I understand that I should report a change of personal information (name, contact information, class of registration, etc.) to the CNPS at the earliest opportunity. In particular, if I am or if I become a nurse practitioner (NP), I must register with the CNPS as such so that I benefit from liability protection for professional activities within the NP scope of practice.

I, your name, understand that CNPS services and, in particular, the provision of professional liability protection and legal assistance do not generally extend to my professional corporation or business entity.

Accepted on: *
Format: 2017-10-19
October 19, 2017

By continuing with this transaction, you hereby certify the content of your application and accept the terms of CNPS services.