Thank you for your interest in getting more involved with Kaiser Permanente. We exist to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.

All of our work is focused on ensuring that we meet and exceed the expectations of our members. Our advisory councils are an important part of this work, as they help us to improve the care experience and promote positive relationships between Kaiser Permanente and our members. They partner directly with us and provide feedback and recommendations to our team.

If you are interested in participating in one of our councils, or to be considered for a future focus group please complete the information below and someone on our team will reach out to connect with you to discuss further.

Thank you for your interest in participating!

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* 1. What type of engagement are you interested in? (Please choose one or both)

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* 2. Personal Information:

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* 3. Please select the Medical Center where you, or your family member(s), primarily receive care:

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* 4. Please provide your Kasier Permanente Medical Record Number

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* 5. What is your age?

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* 6. Why would you like to serve on a KP Advisory Council and/or participate in focus groups?

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