Seeking Patient Advisers to Help Shape the Design and Development of a Comprehensive Outpatient Clinic for the Management of IBD
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* 1. Your Contact Information

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* 2. We are devoted to equity, diversity and inclusion. Please feel free to self-identify as a member of the following communities if you wish:

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* 3. Briefly tell us why you are interested in becoming a Patient Adviser and what experiences you think you can bring to the position.

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* 4. Are you comfortable communicating (verbal and written) in English?

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* 5. Please select if you require a:

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* 6. Please select some of the skills or experiences you may have:

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* 7. Availability - When are you available to attend meetings? (check all that apply)

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* 8. Is the Health Sciences Centre an accessible location for you?

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* 9. Where did you hear about this opportunity?

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* 10. References - Please provide the names and contact information for 2 references.

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