Understanding the care experience from the perspective of our patients and their families is a key factor in delivering health care quality, safety and service. In our ongoing efforts to provide exceptional patient care, we are enlisting the assistance of former patients and their families to share their perspectives, insights and experiences.

We are currently in the process of selecting patients and family members to help us create a sustainable Patient and Family Advisory Council (PFAC). As a member of the Council, you will assist with the development of the structure for the PFAC (membership, frequency of meetings, length of meetings, goals, etc.).

If you would be interested in serving on the PFAC, please complete this short application, or you can pick up a hardcopy at Memorial Hermann Cypress Hospital, 27800 Northwest Freeway, Cypress, TX 77433. Selected applications will be contacted to schedule an interview. If you have any questions, please call Patient Relations at at (346) 231-5923.

Patient and Family Advisory Council Application

20-29
30-39
40-49
50-59
60+
Former Patient
Family Member
Maternity
Day Surgery
Medical
Outpatient
Emergency

REMINDER: WE WILL DO BACKGROUND CHECKS ON ALL COMMITTEE MEMBERS, AND A HEALTH SCREENING (FLU AND TB) IS REQUIRED BEFORE YOU JOIN AND ANNUALLY GOING FORWARD. MEMBERS MUST SIGN A CONFIDENTIALITY AGREEMENT. WE WILL KEEP APPLICANTS IN MIND FOR POTENTIAL OPPORTUNITIES FOR FUTURE PROJECTS.

Thank
You!

We have received your request to join the Patient and Family Advisory Council Application Cypress. A team member will contact you shortly.