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Become an Advisor

Partner with staff and physicians to help improve the care and services we deliver to our community. Bring your unique skills and ‘lived experience’ as a patient or family member to inform key hospital decisions and health system solutions.

Patient Family Advisors are volunteers and receive complimentary parking and refreshments when attending advisor-related meetings and activities. The time commitment is flexible.

Name:

Email Address:

Address (Street / Apt. No. / P.O. Box / R.R. No.):

City/Town:

Province:

Postal Code:

Phone Number:

Preferred Language:

Fluent in Other Language(s):

What is your availability to volunteer?

How long can you commit to being an advisor (in months)?

Select a choice:

I am/was a patient

I am/was a family member of a patient

Why are you interested in being a patient family advisory volunteer?

Describe any skills, experience, or training that you feel may be an asset to becoming a Patient Family Advisor:

If you have served as an advisor, been an active volunteer committee member or provided public service for other programs or organizations, please describe the experience:

References

Identify two people who would be willing to provide a reference to support your application. Please ensure they agree to be contacted.

Name:

Phone Number:

Email Address:

Name:

Phone Number:

Email Address:

Signature:

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Date:

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Become an Advisor

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