Partner with us - Consumer Expression of Interest Form

Have you:

Had a good healthcare experience and want to give back?
Noticed there are opportunities for improvement?
Had a poor experience and want to influence change?

To register your interest please complete this form and a Community and Oral Health staff member will contact you to discuss ways you may be able to partner with us.

Staff of Community and Oral Health, Metro North Hospital and Health Service, elected officials (Local, State, Federal) and lobbyists are not eligible to join. These groups can email MetroNorthEngage@health.qld.gov.au for other options to engage with us.

Please note: If you have specific feedback or wish to make a complaint please go to the online Metro North feedback page https://metronorth.health.qld.gov.au/contact-us

Please register your interest in consumer engagement opportunities at Community and Oral Health, Metro North Health by completing the form below:

Name*

First Last

Telephone Number*

Email*

Enter Email Confirm Email

Please select which services you are engaged with:*

Please select all that apply

Please specify:*

How would you like to partner with us (Please select all that apply)?*

Invitation, involvement and /or support at an event
Provide feedback (project/topic/literature)
Participate in workshop or focus group
Participate in a committee, co-design, redesign or service improvement initiatives
Share my story or map my patient journey
Present as a speaker at training or an event, or conference
Unsure

Other, please specify:

Do you have any other comments?

Information disclaimer

Your personal information will be included in our database. Your details will remain confidential and will only be used for engagement activities coordinated by Community and Oral Health, Metro North Health. You can opt-out at any time by contacting COH-Engagement@health.qld.gov.au.

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Partner with us – Consumer Expression of Interest Form

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