If you would prefer to fill out your application offline and email it to membership@chf.org.au, click here to download a Word copy.CHF provides consumer representatives for a range of health-related committees and working parties. Consumer participation has been shown to improve the quality of health service decisions, systems and outcomes.CHF assists with sourcing consumer representation in two ways. In a select number of cases CHF runs a selection and nomination process (nominating consumer representatives to a limited number of high level national committees and those related to funded priority areas). Where we cannot assist in this way, CHF advertises consumer representative opportunities to our national network, with applications going directly to the committee organisers (CHF does not play a role in the selection or nomination). When CHF does not play a role in the selection or nomination process the successful consumer representative cannot be referred to as a CHF nominated consumer representative. Please allow 3-4 weeks for this process.[1] See Principles for the Appointment of Consumer Representatives: A Process for Government and Industry, Commonwealth Consumer Affairs Advisory Council (Treasury) Final Paper, June 2005Requesting Organisation Details Logged in users may have their information pre-filled on this form. Existing Contact Organization Name Website Street Address Street Address Line 2 City Postal Code State/Province Organisational Contact First name Surname Position Email Phone Number Phone Extension Preferred Communication Method(s) Phone Email Postal Mail SMS Fax Details of Committee Commitee Start Date Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072 Commitee End Date Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072 Name of committee / working group / other Terms of reference / brief description of role Membership composition Are you approaching other consumer organisations for nominees? * Yes No CHF is a national organisation providing representatives for national committees. Some committees have more than one consumer position and may approach other organisations to fill the second seat. CHF needs to be aware of this. Except in the case of Ministerial appointments as prescribed in regulations, we do not submit consumer representatives in competition with other organisations. If you approach us for a consumer representative, we expect that the person nominated by CHF will become the consumer representative on the committee. How often will the group meet? Are Meetings: Face to face By teleconference A combination Date of next meeting * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year20202021202220232024 Number of consumer representatives sought Remuneration for consumer representativesCHF expects organisations to demonstrate their commitment to consumer participation by meeting the expenses incurred by consumer reps and by remunerating them for their time (see the Principles for the Appointment of Consumer Representatives: A process for Governments and Industry, Commonwealth Treasury Consumer Affairs Advisory Council, June 2005). This recognises the fact that almost all other members of a committee will be paid for their time through their professional bodies or salaried employment. Consumers, however, frequently forego their paid employment in order to prepare for and attend a committee meeting. CHF does not put its consumer representatives in positions where they will be financially disadvantaged by their desire to improve health care.Please confirm that your organisation will pay the following expenses, likely to be incurred by consumer representatives. If you are unable or unwilling to meet these reasonable costs, please provide a written justification. In some cases, CHF may still consider your request but will not give it high priority. Travel Yes No It is preferable for you to book and pay for this on the consumer representative’s behalf. Accommodation Yes No If required due to meeting times or health state – again please book and pay on the representative’s behalf. Miscellaneous costs Yes No e.g. parking, printing, telephone calls, childcare Sitting fees at remuneration tribunal rates Yes No If no to any of the above, please provide a justification here. Any relevant documentation? If adding some documentation would help us understand your request, please upload it here.Files must be less than 6 MB.Allowed file types: txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml. Activity Subject * Activity Date * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year20202021202220232024 Leave this field blank