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  • Patient Advisory Cohort Application

  • You are invited to join Rogue Community Health’s Patient Advisory Cohort to provide constructive feedback and recommendations on a variety of topics that directly impact Rogue’s patients and family members.

    The Advisory Cohort meets once a month for 3 to 4 months. Meetings generally take place online using Zoom and require the use of a computer or other smart device. Assistance with technology is available in advance of the meeting.

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  • Please tell us about yourself

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  • Please read before signing:

    As a PAC member, I will:

    • Make every effort to attend meetings

    • Try my best to be on time and fulfill my responsibilities

    • Be courteous and considerate of others

    • Consider all information to be confidential

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  • For more information contact:
    Kim Handloser
    Rogue Community Health
    541-973-1564

  • Statement of Confidentiality

  • All information (e.g., history, name, medical problems, anecdotes) about the patients of Rogue Community Health (RCH) is confidential. Rogue Community Staff will only release confidential patient information when requested to do so by the patient through a signed and dated Release of Information, or by any governing laws and regulations. By signing below, you are acknowledging RCH’s Statement of Confidentiality and agree to maintain the confidentiality of any information to which you may have access, either verbal or written, during your participation on the Patient Advisory Cohort. You further acknowledge that any illegal disclosures are a violation of the Health Insurance Portability and Accountability Act (HIPAA) and could result in civil liability for invasion of privacy.

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