Better Health Together

Title

Given name *

Email Address *

Contact number

Postcode

Year of birth

Gender

Do you identify as a member of the LGBTQIA+ community?

YesNo

Do you identify as Aboriginal or Torres Strait Islander?

YesNo

Do you have lived experience of an illness or chronic condition?

YesNo

Do you have lived experience as a carer?

YesNo

Are you living with a disability?

YesNo

Do you identify as neurodiverse?

YesNo

Is English your first language?

YesNo

If no, would you require the help of an interpreter?

YesNo

What type of activities would you like to be involved with at QIMR Berghofer? *

Select all that apply

Sharing my health story with researchers to help inform the direction of research projectsHelp review lay descriptions of research for grant applications or other documentsHelp craft public messaging for the recruitment of research participantsGive feedback on the way the Institute communicates with the communityProvide advice about how research findings can be translated into clinical practice, policy or educationMeet with researchers to talk about new research ideasParticipate in working groups or committees that help inform the way the Institute worksServe as a member of the QIMR Berghofer Consumer Advisory GroupParticipate in media stories related to my area(s) of interest or experience

What is your health area of interest or experience? *

Select all that apply

If you selected other, please specify here

If you selected cancer, are there particular types of cancer you have knowledge of or experience with?

Select all that apply

If you selected other, please specify here

How did you hear about our Better Health Together register? *

If you selected other, please specify here

Members of the Better Health Together registry are recommended to sign-up to our bi-monthly e-newsletter. This will include any involvement opportunities that are available with QIMR Berghofer and its researchers, as well as other stories or activities that might be of interest.

Tick this box to confirm you are happy to receive our e-newsletter

QIMR Berghofer also has a free quarterly newsletter, LifeLab, which provides readers with cutting-edge medical research and health and well-being updates

What other ways are you happy to be contacted about available involvement opportunities related to your area(s) of interest and experience?

EmailPhone

Better Health Together

Better Health Together

Interest and Experience

COMMUNICATION PREFERENCES