Consumer and Families Panel - Expression of Interest Registration Form

Expression of Interest
This form will ask you for information about your interest in participating in the Aged Care Quality and Safety Commission’s Consumers and Families panel. It will also ask for some information about you.

We will use this information to contact you about panel engagements and to make sure we invite you to share your views on topics most relevant to you.

Please read the Information Sheet before completing this form.
This form should take around 10-15 minutes to complete.

Privacy statement
Your personal information is protected by law, including the Privacy Act 1988 and the Australian Privacy Principles.
Your personal information is being collected via this registration process for the purposes of conducting ongoing consultation about aged care. We will keep your personal information in a database. You can ask to be removed from the panel database at any time.
Click here to find out more information on our website about the way the Commission will manage your personal information.

Consent to collect personal information

To complete registration please tick the boxes below to indicate your consent to the collection of your personal information, including sensitive information and confirm you are 16 years or older below.

I am aged 16 years or older

I consent to participation in this expression of interest process and the collection of sensitive information to be used for the purpose stated.