Speaker Request Form Do you like the CRTO to come and speak at your facility? Submit a request by filling out the form below and we will be in contact with you. * denotes required Last Name * First Name * Organization * City Work Phone * Email * Presentation Information: Requested Date * Requested Time * I am interested in the following presentation topic(s) (check all that apply): The Role of the CRTO / CRTO Update GROW PORTfolio Workshops Scope of Practice Professional Ethics Standards of Professional Practice Registration Requirements and Process Quality Assurance Program Members Responsibilities as Educators The RT in an Interprofessional Model of Care Authorizing Mechanisms (e.g., medical directives) Relevant Legislation, Regulations and Regulatory Requirements (e.g., liability insurance) Members Responsibilities as Educators Other Topic(s) Length of Presentation (in minutes) Anticipated Audience RTs Only Multidisciplinary