Patient Advisory Council Application

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To apply for membership to the UMC Patient Advisory Council fill out the form below and then click “Submit.” You will be contacted with more information by a member of our team when your information is processed. Thank you for your interest in becoming part of this team.

*indicates required information

Have you recently been a patient at UMC Health System?
If “yes,” please indicate where you were a patient.
Would you be available to attend one meeting every quarter for the next year (2017)?
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