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Unity Health Toronto Patient and Family Partner Application

Patient and Family Partner Application

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Thank you for your interest in becoming a Patient and Family Partner at Unity Health Toronto.

For us at Unity Health Toronto, working with Patient and Family Partners provides an important opportunity to collaborate with interested individuals like yourself to learn from your valuable insights and create the best care experience possible.

There are so many ways to get involved. We will work with you to find a volunteer role that will work with your schedule.

We are looking for individuals who:

are at least 18 years of age
must reside in Canada
You are not currently employed by Unity Health Toronto
are a patient or a family member of a patient** who has received medical care at one of our Unity Health Toronto Sites (St. Joseph’s Health Centre, St. Michael’s Hospital or Providence Healthcare) within the past three years
enjoy working in partnership with others
are committed to help and want to make a difference
want to ensure the best care experience for all
commit to a one-year term with option to re-apply

**The term “family member” is used in the broadest sense and is determined by each individual.

As an organization, we are committed to including Patient and Family Partners who reflect the diversity of the communities we serve. We encourage applications from persons with disabilities, racialized persons, First Nations, Inuit and Métis people, people of all sexual orientations and gender identities, and others who may contribute to the diversity of our patient/client populations.

Privacy

Unity Health Toronto is committed to keeping your personal information confidential and secure.

We use this information to:

Check if you qualify for the PFP program
Help match you with the right opportunities in the program

Your information will be kept confidential and it will not be sold, traded or loaned to any other organization.

Estimated completion time for this application is about 10 minutes.

Are you 18 years of age or older? (please note you must be 18 years or older to qualify)(Required)

Yes

ALERT – This response did not meet our eligibility requirement (you must be at least 18 years of age and have been a patient or a caregiver to a patient who has received medical care at one of our Unity Health Toronto Sites within the past three years). Please email patientexperience@unityhealth.to for more information.

Are you a current employee of Unity Health Toronto?(Required)

Yes

ALERT: Your response did not meet our eligibility requirement (you cannot be a current Unity Health staff member). Please email patientexperience@unityhealth.to for more information.

Have you or a family member received medical care at one of our Unity Health sites within the past three years? (please note you must have experience at one of our sites to qualify)(Required)

Yes

ALERT: Your response did not meet our eligibility requirement (you must have been a patient or a caregiver to a patient who has received medical care at one of our Unity Health Toronto sites within the past three years). Please email mailto:patientexperience@unityhealth.to for more information.

At which site(s) have you or a family member received medical care in the past 3 years (please check ALL that apply) (please note you must have experience at one of our sites to qualify)(Required)

St. Joseph’s Health Centre

St. Michael’s Hospital

Providence Healthcare

What was your involvement when coming to one of our Unity Health Toronto sites? (please check all that apply):(Required)

Patient

Family member

Caregiver

Neither

Which program provided care? (please check ALL that apply):(Required)

Adult Day Program

Ambulatory care (Outpatient Clinic)

Bariatric care

Endoscopy (e.g., colonoscopy, gastroscopy, biopsies, polypectomies, endoscopic stent insertion)

Emergency Care (Emergency Department)

Heart, Lung & Vascular (heart care, respirology, heart surgery, vascular surgery)

Hematology

Kidney & Metabolism (diabetes, kidney transplant, renal care, urology)

General Internal Medicine (Inpatient)

Infectious disease clinic (e.g., tuberculosis, bone & joint infections, HIV, fungal infections)

Medical Imaging (e.g., x-ray, MRI, CT, ultrasound)

Mental Health & Addictions

Multiple Sclerosis

Neurology (e.g., seizure disorders, headaches, Parkinson’s disease)

Oncology (e.g., cancer)

Oncology/Hematology inpatient unit

Pain management

Palliative Care

Pediatrics (e.g., children’s health)

Rehabilitation

Seniors Health

Surgery (e.g., general surgery, ophthalmology surgery, neurosurgery, orthopedic surgery)

Stroke

Trauma, Neurosurgery & Critical Care (e.g., Intensive Care Unit, Head Injury Clinic)

Women’s Health (Labor & Delivery, Gynecology, Obstetrics)

Other

Please specify

Why do you want to be a Patient and Family Partner at Unity Health Toronto?(Required)

How did you hear about the Patient and Family Partner program?(Required)

Unity Health Toronto website

Social media

Healthcare Provider

Another Patient and Family Partner

Hospital posters/postcards

Other

Please name

Please specify

I am interested in partnering in the following areas: (Check ALL that apply)(Required)

Participating on staff interview panels

Helping to develop or review informational materials for patients, families and citizens

Providing feedback on helping to develop hospital initiatives, policies, or processes

Providing feedback on program design and delivery

Providing quick feedback and input through a virtual focus group

Helping to educate hospital staff and healthcare providers by sharing my story

Serving as a member of an advisory council

Serving on other hospital committees and /or task forces

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Please indicate the type of Patient and Family Partner role that you wish to apply for:(Required)

I am applying to take part in committee and/or working group activities, and I can make a 1 year commitment.

I am applying to take part in a Patient and Family Council, and I can make a 2 year commitment.

I am applying to both of the above, and I can make a 2 year commitment.

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Why would you like to serve as a Patient and Family Partner at Unity Health Toronto?(Required)

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Are there any particular areas or topics at Unity Health Toronto that you have a special interest in? Please list all (i.e. emergency care, mental health, communications, policy, facilities design)

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Do you have any experiences working on projects or as a member of a committee through paid work or as a volunteer?(Required)

Yes

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Please explain:

Please add anything else you wish to share about yourself (professional experience/skills, other volunteer work, personal experience etc.)

Please let us know when and where you would be able to participate as a Patient and Family Partner.

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At which site are you interested in being a Patient and Family Partner? (Please only select a site at which you have experience as a patient/caregiver/family member)(Required)

St. Joseph’s Health Centre

St. Michael’s Hospital

Providence Healthcare

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If you are interested in becoming a Patient and Family Partner at more than one site, please specify which other site here:

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Your general availability (please choose one):(Required)

Weekdays only

Weekends only

Flexible

Other

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The time during the day that works best for you (please choose one):(Required)

Mornings only

Afternoons only

Evenings only

Flexible

Other

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Would you be able to commit to being a Patient and Family Partner for a minimum of 1 year?(Required)

Yes

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Please explain:

Thank you for sharing your contact information with us. Please be assured that all your information will be kept private and will only be used for the purpose of providing information to you as a Unity Health Toronto Patient and Family Partner.

First name(Required)

Last name(Required)

Street name and number(Required)

City(Required)

Postal code(Required)

Phone(Required)

Email(Required)

The preferred/best way to get in touch with you:(Required)

Phone

Any of the above

Best time to reach you:(Required)

Thank you for your interest in becoming a Unity Health Toronto Patient and Family Partner, and for completing this form. A member of the Experience and Engagement team will contact you once we have received your application. We will discuss next steps with you at that time.

Should you have any further questions about the Patient and Family Partner program at Unity Health Toronto, please email us at patientexperience@unityhealth.to.

Privacy

Unity Health Toronto is committed to keeping your personal information confidential and secure.

We use this information to:

Check if you qualify for the PFP program
Help match you with the right opportunities in the program

Your information will be kept confidential and it will not be sold, traded or loaned to any other organization.

I understand that my personal information will only be shared for the purpose of Patient and Family Partner selection at Unity Health Toronto and that it will not be shared for any other purpose without my permission.(Required)

Yes, I understand

This application was completed on:(Required)

DD slash MM slash YYYY

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Last updated November 03, 2021

July 03, 2025

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