Pain Rehabilitation Advisory Board Application

The Peer and Caregiver Advisory Boards aim to be a volunteer opportunity for former graduates of the PPRC and YAPRC to "pay it forward" and help improve the experience for other participants. Our primary goal for the advisory board is to have speakers present their experience and answer questions during a moderated group session. Additional opportunities to help support our team and participants may present in the future. If interested in this opportunity, please submit the following application.

Committment Requirements

Complete all follow-up appointments as advised by team
Interest in acting as an advisor by thoughtfully answering questions and sharing personal experiences in a group setting.
Availability to meet with Advisory Board members for a 45-minute introductory meeting/training via Zoom
Availability to join a 45-minute participant group (in-person or on zoom) every 2-3 months for at least 6-months (timing to be determined)

Program You Are Applying For:*

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Applicant Type*

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Name*

Age (For Participant Applicants Only)

Phone Number*

Email*

Program Graduation Month/Year*

Why Are You Interested In Becoming Involved? *

Scheduling Constraints

Are there any days/times of the week that you would not be available to meet?

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