Family Advisory Council Interest Form | Children's of Alabama

What is a Family Advisory Council?

A Family Advisory Council, or FAC, brings families and caregivers together with members of the healthcare team. The group works together to improve the care and experience of patients and families.

Members share ideas and talk about their experiences with care. Their feedback helps the hospital learn what works well and what needs to improve. Their input also helps shape care forfuture patients and families.

Member Eligibility and Commitment

Members must be a parent or primary caregiver of a Children’s of Alabama patient who received care in the past three years.

Members agree to serve for a two-year term. The group meets eight times each year. Members should attend at least six meetings. Some meetings offer a virtual option. We hope members attend as many meetings as possible so they can share ideas, listen to others, and connect with the group.

Name

Email

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Your Child's Care

Has your child received care at Children’s of Alabama in the past 3 years?

Yes

No

Which services did your child receive? Select all that apply.

Behavioral Health

Emergency Department

Imaging/Radiology

Inpatient Care

Outpatient Surgery

Specialty Clinic

Other…

Your Interest

Why would you like to join the council?

How did you learn about this opportunity?

What skills or life experiences would you bring to the council?

Tell us anything about yourself that would help bring different ideas or experience to the council. *Our Family Advisory Council reflects the diversity of the patients and families we serve.

Are you able to attend monthly meetings?

Yes

No

Relationships and Other Information

Do you have a relationship with anyone who works for Children’s of Alabama, a vendor, or a partner group? Could this affect your role on the council?

No

Yes. Please explain

Is there anything else you would like us to know?