Toowoomba Integrated Mental Health Hub

Toowoomba Integrated Mental Health Hub

Co-Design Expression of Interest Form
Name*

First NameLast Name
Organisation name (if applicable)
Email*
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Choose the option that best identifies who is submitting this application:*
Please let us know which stakeholder group you would like to join:*
Please tell us a bit more about yourself and your interest in participating with this co-design process:
Availability

This co-design panel will meet for a series of five sessions at the following times:

• Tuesday, 17 September, 10:00am-4:00pm (face-to-face in Toowoomba)
• Wednesday, 25 September, 10:00am-4:00pm (face-to-face in Toowoomba)
• Friday, 27 September, 10:00am-12:00pm (online)
• Wednesday, 2 October, 10:00am-12:00pm (online)
• Wednesday, 9 October, 10:00am-12:00pm (online)

Additionally, co-design panel members would be leading in-community conversations throughout various times on Tuesday, 18 September 2024.
If you would like to participate on the co-design panel, please indicate your availability below:

I am available for all of these timesI am available for some of these timesI am not available for any of these times
Please let us know if you are NOT able to attend any of the proposed sessions:
Data Collection Notice

This survey asks for information about you to help us coordinate our co-design panel/s.

Your information will be kept safe and secure within Australian-based systems. Your information will remain confidential and will only be used for the purpose stated above. If you have any questions about this survey and the information asked, please refer to our privacy policy including how to contact our Privacy Officer.

Please do not submit any personal or sensitive information, such as health records, financial details, or identifiable personal data, unless specifically requested.
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