Consumer Representative Onboarding – Health Consumers Tasmania

Consumer Representative Onboarding Form

This form is for any person that is engaged as a consumer representative with Health Consumers Tasmania. This form helps us to know about you, your support needs and collect important information to ensure you are able to be remunerated for your time as a consumer representative. Please get in touch if you require any support to complete this form or you would prefer to share this information through a confidential one on one conversation – hello@healthconsumerstas.org.au

Phone

This field is for validation purposes and should be left unchanged.

Introducing Me

Name(Required)

First Last

Email(Required)

Pronouns

Dietary Requirement

A bit about me

my skills, my areas of interest and my lived experience:

Would you like to become a Registered Consumer Representative with HCT? This means that we may email you about certain opportunities and keep in touch with information and news that is specific to Tasmanian health consumer representatives.

Yes

No thank you

Accessibility

My access and support needs that you should know about:

(e.g., Auslan interpreter, interpreter, breaks, building access, how I prefer to receive information, technology, support person)

Safety, Privacy and Confidentiality

Safety considerations that could be impacted by this engagement to be aware of:

(e.g., physical safety, emotional safety, or cultural safety)

Ways you can uphold my safety, privacy and confidentiality include:

(e.g., information that should not be disclosed publicly, topics or themes that I am not willing to discuss)

My privacy considerations for use of photos online or in publications or potential media opportunities:

Support

The support and debriefing I would find useful:

(e.g., pre-briefing prior to first meeting or engagement, after the meeting or engagement, bringing a support person)

Consumer Representative Payments

This section is to help us understand your needs and preference in terms of remuneration or payments for engagements that you may be involved in. Prior to any engagement, the person from HCT supporting you will be in touch regarding amounts for remuneration or reimbursements and what may be possible.

How would you prefer to receive remuneration or a payment for activities you may be involved with where this is relevant?(Required)

Bank Transfer

Pre-paid Debit Card – physical card

Pre-paid Debit Card – digital card

Invoice

No remuneration

Account Name

BSB

Account Number

Mailing Address

This must be a physical address and not a PO box. Unfortunately, suppliers will not send a gift card to a PO box.

Street Address City State / Province / Region ZIP / Postal Code

Phone

ABN

For those choosing to invoice, please provide your Australian Business Number below.

Statement by Supplier Form

For any person that is not using an ABN and invoicing HCT for payment, we require a Statement by Supplier form to be completed. This form helps us to know whether or not you need to pay tax on your remuneration payment. Most consumer representatives are involved due to personal interest or as a ‘hobby’ and choose this option on the form. More information and the form are available on the ATO website. Please complete the form and upload it below.

Form and more information

File

Max. file size: 128 MB.

Anything Else

Is there anything else that you think we should know?

Privacy Statement

Privacy Statement We collect your personal information to support your involvement in consumer engagement activities, like sharing updates, inviting you to participate, making remuneration payments or helping to understand your engagement needs. We’ll store your details securely and only use them for these purposes. We follow the Australian Privacy Principles and won’t share your information outside our organisation unless required by law or with your consent. By submitting this form, you consent to us collecting and using your information as described. You can ask to access or update your details at any time. Please also see our Privacy Policy that is linked at the bottom of this page.

Consumer Representative Registration