Subscribe to Engage Consumer Network

Sign up to the Engage Consumer Network by completing the form below. You do not need to tell us everything now however the more we know the more relevant our emails will be.

By joining Engage you will learn about ways to have your say about how the Child and Adolescent Health Service meets the needs of children, young people and families.

You can join as a just a member of Engage or enrole as a consumer representative all in one easy place.

We look forward to working with you.

About you

Please complete the following information about yourself so that we can add you to the Engage Consumer Network.

First Name*

Last Name

What are your preferred pronouns? (eg she/her, they/them, he/him)

Email*

Mobile Phone

Date of Birth

Postcode or ZIP Code

Which description best describes you?*

Young person aged 12-24 years

Parent/carer of a child aged 0-18 years

Parent/ carer of a child who has used CAHS services within the last 5 years

Representative of a community organisation that support children and families

Sibling of someone who has used CAHS services

None of the above

What can we contact you about?

Opportunities to become a consumer representative

Attending consumer events and consultations

Reviewing patient information and other documents

Providing feedback on research

Taking part in research

Only contact me about services I have used

Your experience of the Child and Adolescent Health Service

The following information will be used to send you the most relevant information and opportunities

I have used the following services at Perth Children's Hospital

I have used the following Neonatology services

Neonates Intensive Care (King Edwards Memorial Hospital)

Special Care Nursery 2 (King Edwards Memorial Hospital)

Neonates home visits

nutrition and WA PREM Milk Bank

High Dependency Unit (King Edwards Memorial Hospital)

I have used the following Community Health service

Being a consumer Representative at CAHS

If you are interested in being a consumer representative at CAHS please complete the fields below. This information will be saved and can used or updated to apply for positions in the future.

*If you are not interested in being a consumer representative please ignore this section.

Why are you interested in being a consumer representative? (It can be helpful to include why you are interested in a particular position)

What experience or skills do you think you would bring to the role of consumer representative? (this may include current or past work, voluntary or team work experience)

Is there anything we can do to support you to become a consumer representative?

Please add the name and contact number of someone we can contact as a reference, this could be from work, volunteering roles, school or health.

If you are under 18 please provide your parent/gurdians name and phone number

I consent to Child and Adolescent Health Service collecting and using my information for engagement purposes in accordance with their Privacy Policy.

Subscribe to Engage Consumer Network

About you

Your experience of the Child and Adolescent Health Service

Being a consumer Representative at CAHS

We value your privacy as much as you do. We will not give your information to any other parties