1. Intro
  2. Part I - Demographic Information
  3. Part II - Contact Information
  4. Part III - Care Experiences at Community
  5. Part IV - More About You
  6. Preview Responses

Patient and Family Advisory Council Application

Thank you for your interest in the Patient and Family Advisory Council and for taking the time to complete this application.

PLEASE NOTE: This survey is only for Community Health Network patients or patient family members.

If you have any questions about this application, please call 317-621-7001 or email us.

Are you a current employee of Community Health Network?

Thank you for your interest. At this time, we are not accepting applications from current Community Health Network employees. Regional leaders will identify and appoint employees to participate on the Patient and Family Advisory Council. Your voice is very important to us and we would like you to consider joining the Virtual Advisory Council to share your insight and opinions on specific topics about the patient experience at Community.

Virtual Advisory Council Application