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Canadian Certified Physician Executive Credit Card Payment

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Certification Fee


Personal Information

Credit card information

Credit card type

American Express CIDVisa and Master Card CID
American Express: The CID is located on the front of your card.
Visa and Master Card: The CID is located on the back of your card.

Receipt of your application package will be acknowledged upon receipt. Send payment, completed application form, your self-assessment and other required documentation electronically to or by mail to the address below. Please keep a copy of your complete application package for your files.

If you have questions, contact the CCPE Secretariat:
by email at
by telephone at 613 369-8322 x 200

Mail to:
c/o Canadian Society of Physician Leaders
Suite 323 - 875 avenue Carling Avenue
Ottawa ON K1S 5P1