Please ensure that you have reviewed the Southlake Website before completing the volunteer application.

Please complete all areas of the application. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. 

Fields marked with an * asterisk are required fields. If you do not wish to submit your application, you may exit this form at any time by closing your browser. All information will be lost.

Personal Information
Are you currently a Volunteer at Southlake Regional Health Centre?
Emergency Contact Information

In the past five years have you received care or supported someone recieving care at a hospital?
Please indicate which department(s)

What are your reasons in applying for a Patient and Family Advisor volunteer position at Southlake Regional Health Centre?
Volunteer Opportunities
We have two types of opportunites: 
  • Patient and Family Advisor Council(PFAC)- is a council of people made up of both patients, family members and staff members who partner to advise and support the strategic direction of Southlake in matters that relate to the patient and create an environment where the best expereinces happen at the corporate and clinical level

  • Patient and Family Advisory Pool (PFA Pool) - is a group of PFA's that are not active members of a PFAC. The PFA Pool provides the opportunity to select "calls for participation" that best meet their availaibility. The PFA may be able to participate remotely (e.g. review of patient educational materials or policies). A few examples of "calls for participation" are; Southlake committees, special projects, intiatives, workshops, patient educational materials reviews, policy and procedure reviews, ministry requests, ect.

Please indicate which opportunity you would are most interested in:

Please read and check the following:
Vulnerable Sector Police Check
  • Results of a negative 2-step Tuberculosis (TB Test)
  • Proof of current immunizations
  • A signed confidentiality/security agreement
  • One Reference
  • Signed organization/volunteer agreement

Southlake thanks you for your interest in Patient and Family Advisor volunteer position.

The personal information contained in this application is collected pursuant to the Public Hospital Act and the Freedom of Information and Protection of Privacy Act (FIPPA), and will be used for the purpose of the Patient and Family Advisor selection and placement processes at Southlake.

This information wil not otherwise be shared without permission from the applicant/guardian.

Due to the fluctuations in our requirements for volunteers and the suitability of applicants, we cannot guarantee that every appplicant will obtain a volunteer placement.