Council Application

Councils at All Children's Hospital welcome applications for new members.

Our councils consist of groups of parents and teen patients who meet with hospital staff to help promote patient and family-centered care. The councils provide positive and constructive feedback on the patient experience. Council members also help support sensitivity to the emotional, cultural and spiritual needs of our families and patients.

Members include parents and teen patients (age 13-18) who have experience with a variety of children's health conditions and the inpatient and/or outpatient areas at All Children's Hospital.  

Members serve a two-year term. Sometimes there are additional events (such as a panel discussion during Nurses Week) that council members are invited to attend. We welcome applications throughout the year.

Membership Requirements

Members are expected to attend the monthly meetings, be an advocate for positive change, actively participate and listen to others, and attend a mandatory new member training session.

If you are interested in becoming a member please submit the application below:

Applying for * 
2014-2016 Family Advisory Council 
Advocacy Council 
Biorepository Specimen Access Committee 
Patient Care Services Safety and Quality Council 
Teen Virtual Advisory Council 
The Patient & Family Education Committee 
First Name * 
Last Name * 
Email Address * 
Phone * 
Address 2 
Language(s) You Speak 
Contact Sharing  Will you allow your contact information to be shared with other committee/advisory council members?
I am * 
Family Member of an ACH patient 
Patient's First Name 
Patient's Last Name 
Care Type  My child's care provided at All Children's Hospital was primarily:
Hospitalization (Inpatient) 
Clinic Visit (outpatient) 
Both inpatient and outpatient 
Emergency Center Care 
Other Programs 
Care Dates  Dates of my child's care at All Children's Hospital:
2009 to Current 
Why would you like to serve as an advisor? 
Experience  If you have served as an advisor, been an active volunteer committee member, or done public speaking for other programs or organizations, please breifly describe this experience:
Priorities  If asked to talk to a group of health care professionals, please give us an example of the three most important pieces of insight you would like them to take away from your presentation:
Reference  Is there a health care professional with whom you would feel comfortable asking to support your nomination?
If yes, may we contact them? 
Phone Number 
Validation *  Please enter in this field. This is required in order to reduce spam.
* Required


All information contained in this form is considered to be confidential and is intended for use by the All Children's Hospital council membership committees. Each committee will maintain appropriate and confidential handling of personal information as stated in HIPAA guidelines and is presented in volunteer training. Qualified applicants will be selected to participate in a face-to-face interview. If selected, all council applicants must complete volunteer service requirements as assigned by All Children's Hospital.