Register Your Interest - McGrath Model of Care for all cancer

To co-design the McGrath Model of Care for all cancer, Ethicol will be undertaking consultation with a variety of stakeholders from the cancer sector, including people with an experience of cancer (past or present), carers or family members, clinicians and stakeholders from the NGO sector.

If you would like to register your interest in participating in either a workshop or an online survey, please fill in the details below.

Name: *

Email Address *

Mobile number:

Location (postcode): *

State *

Select the category which reflects your relationship with cancer *

Person with cancer (either past or present)Carer or family member of someone with cancer Nurse Other ClinicianOther

What gender do you identify as? *

Man/MaleWoman/FemaleNon-binary/ genderqueer/gender-fluidPrefer not to sayI use a different term

What term do you use to describe your gender?

How do you describe your sexuality *

Heterosexual or straightLesbianGay or homosexualBisexualPansexualQueerPrefer not to sayI use a different term

What term do you use to describe your sexuality?

Do you identify as an Aboriginal and Torres Strait Islander? *

AboriginalTorres Strait IslanderAboriginal and Torres Strait IslanderNone

Select the most appropriate age bracket *

18-2425-3435-4445-5455-6465-7475 and over

Do you identify as being from a culturally and linguistically diverse community?

YesNo Prefer not to say

Do you own a Health Care Concession Card?

Yes NoNot sure

What cancer were you (or your loved one) diagnosed with? *

What is your role?

What type of nurse are you? *

Other nurse

What is your clinical discipline? *

Other clinical discipline:

What types of cancer do you provide care for? *

Who is your primary employer? *

Other:

Approximately how many years have you worked in the cancer sector? *

What is your highest level qualification? *

Other qualification

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