To apply for UW Health's Patient and Family Advisor Partnership Program, complete the form below and select the Submit button.
Please do not submit urgent questions about your medical care through this website.If you are experiencing a life- or limb-threatening emergency, call 911. If your need is urgent, call your clinic for assistance.
I am interested in:
I am a:
Relationship to patient:
Languages spoken at home:
Have you ever been a volunteer for UW Health?
Have you ever been an employee for UW Health?
PFA Interest and Availability
Areas of interest (check all that apply)
Projects related to a disease or service line. Please list all that apply.
Do you have flexibility with your schedule during normal business hours? Please explain
Please briefly indicate why you are interested in becoming a Patient and Family Advisor.
UW Health will endeavor to ensure that any physical and communication barriers do not exclude people from attending and participating. Please let us know of any special accommodations you may need so we can address this accordingly.
Please list any potential conflicts of interest that you may have.
Donations to UW Health are managed by the University of Wisconsin Foundation, a publicly supported charitable organization under 501(c)(3) of the Internal Revenue Code.