Thank you for your interest in our Patient and Family Advisory Councils.  

Requirements necessary in order to be considered for the PFAC  

  • Embrace our Values
  • Be respectful of others and their opinions, exhibit good listening skills
  • Show compassionate and be non-judgmental
  • Be accountable for protecting the privacy of our patients
  • Collaborate to achieve positive healthcare outcomes
  • Willingness to learn from others and allow them to learn from you
  • Selection and Appointment Process
  • Prospective members must be an active, existing patient or a family member of a patient.
  • Complete an application and background check.
  • Will be screened, interviewed and selected by PFAC Co-Chairs or designees.  
  • Will participate in annual mandatory orientation and training.
  • Once appointed, members will serve for a term of two years.  
  • Meetings and Responsibilities
  • Council meets 10 months out of the year.  Meetings are 60-90 minutes.
  • At least 50% attendance at meetings is required.
  • Preparation, engagement and constructive feedback are encouraged.
 

 

VOLUNTEER INFORMATION/INFORMACIÓN DEL VOLUNTARIO O VOLUNTARIA

EMERGENCY CONTACT INFORMATION

VOLUNTEER INFORMATION
Please select which Patient and Family Advisory Council you are interested in serving on.
EDUCATION AND EMPLOYMENT INFORMATION
PHOTO RELEASE:
As a Harris Health volunteer, I realize that my image may be taken at hospital celebrations and other media events. I give my permission to Harris Health to use my image in any appropriate and related materials that will promote or otherwise publicize my experience at Harris Health.*

BACKGROUND CHECK AUTHORIZATION:
Choose if you have ever been convicted of or been on defferred adjudication for, or are you now either awaiting trial for or on deferred adjudication for, a felony or misdemeanor.
CONFIDENTIALITY AGREEMENT:
I agree to use confidential or proprietary information only as needed to perform my volunteer duties.  This means I will not access confidential or proprietary information without legitimate need/permission, nor in any way divulge, copy, release, sell, lend, revise, alter, or destroy any confidential or proprietary information belonging to Harris Health System.  I understand that I will be automatically dismissed as a volunteer if I do not respect my responsibility for maintaining confidentiality.

 

If accepted as a Harris Health System Volunteer, I agree to the following: