To become a Patient and Family Centered Care Advocates, complete application available below or contact Stacey Rush at (724) 223-3175.

Patient and Family Centered Care Application

Last Name
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First Name
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MI
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Address
123 Awesome St.
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City
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State
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Zip Code
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Home Phone
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Mobile Phone
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Contact Email
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Re-Enter Email
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Language(s) You Speak
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I have been
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Please Describe
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The care provided at Washington Health System Washington Hospital was primarily
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Please describe your experience with the above areas
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What are some specific things that health care professionals did or said that was most helpful to you and your family?
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What are some specific things that you or your family would like health care professionals to do differently in order to be more helpful?
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Why would you like to be a Patient Family Advisor?
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Do you have health care experience?
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Please Describe
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Do you have areas of special interest or expertise to offer?
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Please Describe
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I would be interested in helping with
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Please Describe
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Please list when you are able to attend meetings
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Apply