We invite you to join the Canadian Arthritis Patient Alliance in the fight against arthritis.

Benefits

Interaction with other arthritis advocates across the country
Opportunity to post a comment on the CAPA Discussion Board
Information updates on advocacy issues as they happen
Helping to make a difference

CAPA has no membership fees. Once you have filled out the form below and clicked "submit" you will receive an email message to confirm that your information was received and to welcome you to the CAPA organization.

Registration

Required information is indicated by *.

Type of Membership
Full CAPA membership carries with it voting privileges and is intended for Canadians with arthritis. Other individuals with an interest in arthritis advocacy such as family, friends and international guests will be designated Associate Members.
Type of Membership	*	Are you a Canadian citizen with arthritis? Are you a citizen of another country with arthritis? Are you friends or family of a person with arthritis?
Login Information
Email Address	*
Confirm Email Address	*
		Please note that the email address you provide will also be used as your username.
Screen Name	*
		Screen names refer to a public name that can be used to 'screen' one's true username from the public eye. If you leave this field blank, your screen name will be the same as your email address.
Password	*
Confirm Password	*
Contact Information
First Name	*
Last Name	*
Address	*
Address 2
City	*
Postal Code	*
Country	*
Province	*
Daytime Phone number
Evening Phone number
Fax
Medical Information
CAPA requests this information to appropriately represent the many different types of arthritis in our education and advocacy efforts.
Type of Arthritis		Ankylosing Spondylitis Carpal Tunnel Syndrome Childhood Arthritis Chronic Back Injury Fibromyalgia Gout Infectious Arthritis Lupus Lyme Disease Osteoarthritis Osteoporosis Pagets's Disease Polymyalgia Rheumatica Polymyositis and Dermatomyositis Pseudogout Psoriatic Arthritis Rayaud's Phenomenon Reactive Arthritis Reiter's Syndrome Repetitive Stress Injury Rheumatoid Arthritis Scleroderma Sjogrens Syndrome Spondyloarthritis Not Applicable
Age of onset of arthritis
Medication(s) or Treatment(s)		Antibiotics Gold Alternative Medicine Disease-modifying anti-rheumatic drugs Prednisone Cortisone Non-steroidal Anti-inflammatory Drugs Biologics Other
Other Information
Are you a health care worker?		yes no
If "yes", type of technical or professional skill or nature of employment
Advocacy Experience		Extensive Some Little None
Public Speaking		Extensive Some Little None
Areas of Interest		Access to Health Professionals Access to Medications Advocacy Training Arthritis Research Communications Disability Education Elections Juvenile Arthritis Member Outreach Pain Issues
If "other", please specify
Involved in other arthritis related organizations?		yes no
If "yes", please specify role
Notes/Comments
image verification	*	Please enter the word you see in the image above

Benefits

Registration

Type of Membership

Login Information

Contact Information

Medical Information

Other Information