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PFAC Application

River Hospital is creating an advisory council of patients and their family members. Members will be asked to give feedback to the organization on how to improve services. Eligible candidates are those individuals who are solution focused and willing to invest their time and energy to make River Hospital a wonderful place to receive care. We are looking for representation from across our community. The questions we ask are to ensure representation from diverse community members.

The Council will meet on a regular basis (monthly or quarterly – depending on projects and the group). 6-8 candidates will be selected to participate. If you are not selected for the initial council, we would like to keep your application on file for future openings on the council.

Thank you for your interest in the Patient and Family Advisory Council. Please direct any questions to River Hospital’s Director of Marketing and Community Relations, Andrea Pfeiffer at 315.482.1270 or This email address is being protected from spambots. You need JavaScript enabled to view it.


Contact Information

What is the best way to contact you?
Home
Work
Cell
Email
Please check all that apply
I am a patient at River Hospital or River Family Health Center
I am the family member of a patient
I am a patient with a chronic health condition (e.g., diabetes, heart failure, asthma, depression, arthritis)
I am involved in the care of someone who has a chronic health condition
I am a patient/family member receiving preventative and/or occasional illness care

Background

Would you be able to commit to two hours a month?
Yes
No

References

Personal Reference

Professional Reference

Availability

Please check the Day(s) and Time(s) you are available to meet for an interview and/or informational session

Mornings
Monday
Tuesday
Wednesday
Thursday
Friday
Afternoons
Monday
Tuesday
Wednesday
Thursday
Friday
Evenings
Monday
Tuesday
Wednesday
Thursday
Friday

Thank you for applying to be a member of our Patient and Family Advisory Council

Any questions? Please contact River Hospital’s Director of Marketing and Community Relations, Andrea Pfeiffer at 315.482.1270 or This email address is being protected from spambots. You need JavaScript enabled to view it.