Prior to completing this form, please read the information on the Foot Canada Training Curriculum page and contact us if you have any questions.

Note that some regulatory bodies have regulations in place specific to who may teach nursing foot care and what curriculum can be used. Please contact your province or territory's nursing regulatory bodies for more information before purchasing this license.

Product

By completing the form below you are requesting to purchase a 3 year renewable license for the following Foot Canada Training Curriculum:

• Onsite Clinical Foot Care Nurse course (6 days/43+ hours)
• Onsite Clinical Refresher course (1 day/8 hours)
• Advanced Foot Care Nurse Skills Workshops:
  • Diabetic Foot Care Management
  • PAD & ABPI
  • Infection Prevention and Control
  • Podiatry Instrument Skills
  • Private Practice
  • Wound Care
  • Padding & Orthotics - In development

Review Period

Forms received are reviewed within 1-3 business days. Once reviewed, a member of our team will be in touch by email with all eligible education providers to provide a copy of the license agreement for your signature and an invoice with payment instructions.

Purchasing Representative Details

Signing Authority

If the person completing this form is different than the person who will be signing the licensing agreement, please provide the details for the signing authority below:

Lead Educator

Purchase Options

Purchase Option 1 (Discount) - Foot Care Nurse Educators, as well as colleges, universities and health agencies that have an Educator that meets the following requirements are eligible to purchase the curriculum license for a 50% discount. The discounted rate is $2,500.00 + tax for a term of 3 years and is renewable for $500/year after the initial term has expired.

• Nursing License - Current and non-restricted Nursing Registration/License from a Canadian territory or province
• Qualifications - ​Online Foot Care Nurse Theory course *2017 or later and Online Foot Care Nurse Educator course

Purchase Option 2 (Full Price) - Foot Care Nurse Educators, as well as colleges, universities and health agencies that have an Educator that meets the following requirements are eligible to purchase the curriculum license at the full price of $5,000.00 + tax for a term of 3 years. The license is renewable for $500/year after the initial term has expired.

• Nursing License - Current and non-restricted Nursing Registration/License from a Canadian territory or province
• Experience Requirement - 750 hours of nursing foot care practice in the past 5 years
• CAFCN - Valid Canadian Association of Foot Care Nurses membership

PURCHASE OPTIONS NOTES

• We recognize that each organization has its own hiring criteria when choosing an educator and that the educator may already have equivalent education and experience to that which is provided by Foot Canada Training's Educator course. Purchase option 2 is provided in recognition that each education provider is responsible to ensure that their educator is both qualified and competent. If your educator does not meet the criteria for purchase option 1, we strongly recommend screening to ensure that equivalent education and experience has been met.
   
• The FCN Clinical course and FCN Clinical Refresher course curriculum was developed with the intention that students would first complete the ​Online Foot Care Nurse Theory course. This is the best way to help ensure that students arrive to your clinical courses prepared with a strong theoretical foundation and ready to practice their nursing foot care skills. Whether or not your educator chooses to take our FCN Educator course, we highly recommend they complete the Online Foot Care Nurse Theory course *2017 or later to understand the knowledge students will arrive with when coming to class. Experienced Foot Care Nurses can complete this course at the discounted tuition rate of $250 + tax, within an estimated completion time of 20-30 hours depending on how familiar they already are with the course material.

If selecting purchase option 2. Please provide the following supporting documents on the same day this form is submitted.

Supporting documents

• Professional Reference - Your Lead Educator is required to have accumulated 750 hours of nursing foot care practice in the past 5 years. To validate this requirement, the Lead Educator's employer or a foot care health professional having worked closely with your Lead Educator must complete and submit the Professional Reference form. 
  
  Lead Educators may have more than one reference complete this form if each reference can only validate a portion of the total years of nursing experience or total hours of nursing foot care required. For example, if 300 hours are completed with one employer and 450 hours are completed with another, both employers will need to complete this form for the hours they are able to confirm. The total hours of both references would then be used to validate the applicant has met the prerequisite. 
• CAFCN Membership - Your Lead Educator is required to be a current member of the Canadian Association of Foot Care Nurses (CAFCN) and must email an electronic copy of their valid CAFCN membership card and/or membership purchase receipt showing current registration to footcarenurseprogram@gmail.com on the same day the Curriculum Purchase Request Form is submitted. The email subject line must contain the last and first name of the Lead Educator and be formulated as follows: LAST, FIRST - CAFCN Membership. 

Keep in Touch

Were you referred to us by an education provider with a license to use the Foot Canada Training curriculum?

PLEASE REVIEW YOUR FORM PRIOR TO SUBMITTING TO ENSURE ALL INFORMATION INCLUDED IS COMPLETE AND ACCURATE.