Information for parents and family from Medical City Children’s Hospital, one of the leading Texas children's hospitals.
 Family Advisory Board Application

Medical City Children’s Hospital is recruiting family leaders to serve on the Family Advisory Board, which promotes and supports family-centered values throughout the hospital. By advocating for respectful and effective partnerships between families, professionals, and the community, the Family Advisory Board ultimately helps increase patient and family satisfaction.

Requirements of Family Advisory Board Members include:

  • Participating in meetings the first Tuesday of each month from 6:30 - 8:00 p.m.
  • Good listening skills and an ability to see many points of view.
  • Ability to communicate and work with families and staff whose backgrounds, experiences, and styles may be very different from their own.
  • Enthusiasm about the hospital’s mission of excellence in patient care, education, and child advocacy.
  • Ability to share both positive and negative experiences in a constructive way.

If you are interested in participating on the Medical City Children’s Hospital Family Advisory Board, please fill out the application below. Note that applications are reviewed once a year — usually in the spring. The nominating committee will conduct phone interviews with all applicants.


Required fields are marked with *

First Name (*)

Please type your first name.
Last Name (*)

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E-mail (*)

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Home Address

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Daytime Phone

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Best day/time to call

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Evening Phone

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Best day/time to call

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Why would you like to be involved on the Family Advisory Board?

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We believe the Family Advisory Board should reflect the cultural diversity of families who are consumers of hospital services. Please share anything about your family that you think would add to the diversity of this program. You might consider your diversity to be: ethnic, racial, spiritual, social, economic, educational, geographic, gender, sexual orientation, unique family structure, disability related, chronic illness, single parent, full time parent, grandparent, etc.

Is there anything else you would like us to know?

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Child’s Name

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Birth Date

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Has he/she been a patient at Medical City Children’s Hospital?

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Child’s Name

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Birth Date

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Has he/she been a patient at Medical City Children’s Hospital?

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Within the past two years have you used any of the following services at Medical City Children’s Hospital? (check all that apply)










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If other, please describe

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This section is optional. The questions are designed to help us make our committee as diverse as possible.

Ethnicity

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Race

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Reference
Please include the name of a Medical City Children’s Hospital staff member who may be able to provide a reference for you (doctor, nurse, social worker, child life specialist, medical family therapist, guest relations representative, housekeeper, physical therapist, etc).

Name

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Department

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I understand that completion of this application does not bind the applicant or the program coordinators in any way. The Family Advisory Board reserves the right to choose participants that best meet the needs of the program. Before participating in the Family Advisory Board you will be asked to sign a confidentiality agreement.

 

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