Please note: * denotes a required field. Each required field has to be completed before the form can be submitted.

	Contact Name:*
	Organization:*
	Address:*
	Province:*	Please Select... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon **
	Tel:*
	Fax:*
	Email:*
	Image Verification:*	Please enter the number you see to the right:

Promote the Local Best Practice of your center This section allows you to give specific examples of how your center follows the three key principles outlined in the ACT Charter. The details you provide will be printed on the ACT Charter Poster which will be sent for display on your premises. Please use simple and concise language when filling in the details in the boxes below. Click here to see an example of the ACT Charter Poster completed with details of the Local Best Practice.

	Information We will: - Provide clear and accurate information - Provide further information on different treatment options available to you
	Local Best Practice:
	Support We will: - Help you find best means of support from the wide variety of options - Keep up-to-date with other relevant support groups - Provide information on how you can lodge a complaint with your clinic or health professional
	Local Best Practice:
	Choice We will ensure that you: - Are informed about social and medical choices available
	Local Best Practice:

By registering your center you are promising to abide by the ACT Charter's principles to ensure your patients receive the best possible care through the assisted conception pathway and at an appropriate pace. You also promise to ensure patients' progress through any current intervention if it is proving unsuccessful i.e. avoiding any stagnation on any point.

By registering for ACT Charter status your center will become recognized as being committed to the Charter's principles.

Once you have registered you will receive the Charter Pack for your own use, which contains:

• Charter Poster for display (Portrait)
• Charter Commitment for display (Landscape)
• Charter Booklet for printing and distributing to interested parties
• Pathway Booklet for printing and distributing to interested couples who are trying to have a baby
• ACT logo for use on stationery as part of the center's branding to signify affiliation with ACT

Back to top of page.


** List excludes UK