TVCC Client Advisory Council Voice Application

Thank you for your interest in sharing your voice with Thames Valley Children’s Centre (TVCC). We’re so glad you want to contribute to help us be our best. We are currently seeking Advisory Council Members, Virtual Partners and Storytellers.

The Advisory Council meets monthly at TVCC to discuss and advise on TVCC programs, developments, updates and new initiatives. The TVCC Client Advisory Council Voice (CAC) helps to promote client and family-centred care. The CAC provides a voice for client families. You can participate in person or by video/teleconference.

Virtual Partners provide feedback on documents through email and share input through surveys.

Storytellers share their stories in person, video or in print. These stories help TVCC staff and families learn more about what we do well and where we can grow.

These questions will help us learn more about how you want to be heard.

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* 1. Are you a

Past TVCC Family Member

Current TVCC Family Member

Past TVCC Client

Current TVCC Client

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* 2. The dates of my/my family member's active care at TVCC include (select all that apply)

before 2000

2000 - 2005

2006 - 2010

2011 - 2015

2016 - present

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* 3. Within the past five years, what TVCC programs or services have you or your family member used?

Ability Connections

Acute Pediatric Rehab

Adapted Fitness Centre

Adaptive Technology

Augmentative Communication

Autism & Behavioural Services

Bike Clinic

Specialty Clinic (e.g. spina bifida, cleft-lip palate, etc.)

Early Childhood Services (OT, PT, SLP)

Gait Analysis

Just for Moms/Caregivers

Caregivers Connecting

Kids on the Block

PABICOP

Parent Mentor Services

School Therapy Services

Seating & Mobility

Social Work Services

Splinting & Casting

Therapeutic Recreation

Youth Discovery

Youth for Youth

Educational Workshops

TVCC or TR Open House

Summer Camp/Program

Early Childhood Playgroup/Program

Fee for Service Program

Other (please specify)

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* 4. Why are you interested in sharing your Voice at TVCC?

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* 5. What are some specific things that TVCC staff do/have done to help you and your family?

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* 6. What could improve the experience of families/clients at TVCC?

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* 7. Please finish this sentence: "I will feel my Voice has been heard when..."

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* 8. Please describe to us any assistance we could provide to support your participation in sharing your voice.

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* 9. Are you interested in:

becoming a member of the Client Advisory Council Voice, which meets monthly throughout the year (attendance can be in person, teleconference or videoconference) to discuss and advise on TVCC programs, developments, and updates.

becoming a Voice Virtual Partner by providing feedback on documents through email and sharing input through surveys?

becoming a Voice Storyteller by sharing your experience with staff and/or other families?

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* 10. We will use this to contact you about the CAC Voice opportunities you agree to above.

Full Name

Address

Phone Number