Consumer Representative Remuneration Quick Onboarding

Consumer Representative – Remuneration Details Form

This form is so that we know your preferences for remuneration for a one-off focus group or engagement, without undertaking our more comprehensive consumer representative registration process. 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

Comments

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Personal Details

Name(Required)

First Last

Email(Required)

Pronouns

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.

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 Remuneration – Quick Onboarding

Consumer Representative – Remuneration Details Form

Personal Details

Consumer Representative Payments

Anything Else

Privacy Statement