Events

Calendar of Events
Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
26	27 Fresh Truck (Woodlawn Health Center)	28	29	30	31 Board of Directors Meeting	1
2	3	4	5 Fresh Truck (Dr. Jorge Prieto Health Center)	6	7	8
9	10 Fresh Truck (Provident Hospital of Cook County) Arlington Heights Health Center Community Advisory Council Meeting	11	12	13	14	15
16	17	18	19 Fresh Truck (Arlington Heights Health Center) Joint Cottage Grove and Robbins Health Centers Community Advisory Council Meeting	20 Fresh Truck (Ruth M. Rothstein CORE Center) Human Resources Committee Meeting Managed Care Committee Meeting	21	22
23 Finance Committee Meeting Quality and Patient Safety Committee Meeting	24 Fresh Truck (Logan Square Health Center)	25	26	27	28	29
30	1 Fresh Truck (North Riverside Health Center)	2	3 Fresh Truck (Austin Health Center)	4 Board of Directors Meeting	5	6

Name*

First Name Last Name

Address*

Street Address Address Line 2 City State ZIP Code

Home phone

Cell phone

Email address*

Preferred contact (choose one):*

The following questions will help us get to know you better.

Are you a...*

Patient
Caregiver or family member of a patient
Local community leader
Representative of a religious organization
Staff member of a community development organization
Healthcare professional

If a patient or family member, when was your care experience at this Clinic? (Check all that apply).

2017 to current year
2016
2015
2014
2013 or before

What language(s) do you speak?*

We recognize that our community advisors have busy lives. How much time are you able to commit? (Check one)*

Are you available to serve as an advisor for at least 3 years?*

You can still support the Advisory Council if you answer "no."

How do you want to help? I want to:*

Serve as a member of the Citizen Advisory Council. Advisory Council members should be ready to commit to serving on for at least 2-3 years. The Council meets once a quarter for 1 ½ to 2 hours.
Make thoughtful recommendations on issues affecting Clinic operations, patient services and quality improvement projects.
Strengthen communication and collaboration among patients, families, caregivers and staff.
Partner with staff on short or long-term projects.
Promote clinic services to clinic constituency.
Fundraise for special clinic projects.
Staff community health fairs and other educational activities
Ensure everyone has access to healthcare by supporting health insurance enrollment outreach efforts.
Other issues (please describe):

Other:

Please tell us about yourself.

Why do you want to serve on the Community Advisory Committee?*

Briefly describe any experience you may have as a community leader or public speaker.*

List employment and/or volunteer experience.*

Check skills, experience and/or education.

Special skills*

Fundraising
Personnel/Human Resources
Marketing/Public Relations
Finances
Technology
Legal
Management
Other

Professional background*

For-profit business
Nonprofit
Government
Other (please specify):

Other:

Education*

Some high school
High school graduate
Some college
Undergraduate college degree
Some graduate coursework
Graduate degree or higher
Other (please specify);

Other:

Other affiliations:

Board or committee service:

Finally, which locations are you interested in participating:

Arlington Heights Health Center, 3250 N. Arlington Heights Road, Arlington Height, IL 60074
Blue Island Health Center, 12757 S. Western Avenue, Blue Island, IL 60406
Cottage Grove Health Center, 1645 S. Cottage Grove Avenue, Ford Heights, IL 60411
Englewood Health Center, 1135 W. 69th Street, Chicago, IL 60621
North Riverside Health Center, 1800 S. Harlem Avenue, North Riverside, IL 60546
Provident Hospital/Sengstacke Health Center, 500 E. 51st Street, Chicago, IL 60615
Robbins Health Center, 13450 S. Kedzie Avenue, Robbins, IL 60472

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Name

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Events for November 2020

Calendar of Events

Fresh Truck (Woodlawn Health Center)

Board of Directors Meeting

Fresh Truck (Dr. Jorge Prieto Health Center)

Fresh Truck (Provident Hospital of Cook County)

Arlington Heights Health Center Community Advisory Council Meeting

Fresh Truck (Arlington Heights Health Center)

Joint Cottage Grove and Robbins Health Centers Community Advisory Council Meeting

Fresh Truck (Ruth M. Rothstein CORE Center)

Human Resources Committee Meeting

Managed Care Committee Meeting

Finance Committee Meeting

Quality and Patient Safety Committee Meeting

Fresh Truck (Logan Square Health Center)

Fresh Truck (North Riverside Health Center)

Fresh Truck (Austin Health Center)

Board of Directors Meeting

Community Outreach Worker

Email: xhair@cookcountyhhs.org

Phone: 312-752-2705

Community Outreach Worker

Email: acollins3@cookcountyhhs.org

Phone: 708-633-3602

Alice is committed to engaging diverse communities and is passionate about sharing Cook County Health’s motto, “We Bring Care to the Community”.

Director of Community Affairs

Email: mgarcia6@cookcountyhhs.org

Phone: 312-864-0928

The following questions will help us get to know you better.

Please tell us about yourself.

Check skills, experience and/or education.

Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
						1
2	3	4	5 Fresh Truck (Dr. Jorge Prieto Health Center)	6	7	8
9	10 Fresh Truck (Provident Hospital of Cook County) Arlington Heights Health Center Community Advisory Council Meeting	11	12	13	14	15
16	17	18	19 Fresh Truck (Arlington Heights Health Center) Joint Cottage Grove and Robbins Health Centers Community Advisory Council Meeting	20 Fresh Truck (Ruth M. Rothstein CORE Center) Human Resources Committee Meeting Managed Care Committee Meeting	21	22
23 Finance Committee Meeting Quality and Patient Safety Committee Meeting	24 Fresh Truck (Logan Square Health Center)	25	26	27	28	29
30