PFAnetwork Membership Survey
Welcome to the PFAnetwork! Thank you for taking some time to complete this PFAnetwork Membership Survey. We invite you to tell us a little about yourself and your work as a Patient Family Advisor. (We use the term Patient Family Advisor to refer to anyone using their lived experience in the health system to influence it). The more we understand your Advisory activities, priorities, and interests, the better we can support your efforts. Advisors of all experience levels are invited to join the PFAnetwork to connect with peers, develop skills, and engage with new efforts seeking the patient and family perspective!

This survey includes open-essay responses and should take 10 to 15 minutes to complete.
Email address *
First Name *
Last Name *
Email Address *
Phone Number *
Address *
City *
State *
Birthdate (xx/xx/xxxx) *
Communication Preference *
I am a... *
Required
Work Status *
Job Title
Languages Spoken *
Required
Ethnicity
Tell us about the healthcare experience that brings you to the role of Advisor. (Your patient or family caregiver story) *
Please list the organizations you've partnered with in the past (it's okay if you have not yet) :
How comfortable are you with using virtual meeting platforms? (Webex, zoom, skype etc) *
I am available via phone call
I can confidently access most leading virtual meeting platforms
In what year did you start serving as an Advisor? *
Which activities have you been involved with as a Patient Family Advisor? Click all that apply
A copy of your responses will be emailed to the address you provided.
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