FCBC Caregiver Voices Panel – Recruitment Questions

FCBC Caregiver Voices Panel – Recruitment Questions
We’re inviting caregivers from across BC to share their experiences and help improve support for others. By filling out this form, you can tell us about your caregiving background, the types of activities you're interested in (like surveys, focus groups, or story sharing), and how we can best connect with you.

Everyone’s journey is different, and all voices are welcome — whether you're currently caregiving or have in the past. Your input can make a real difference.
Contact Information
Full Name*
Email*
Phone number*
Caregiving Background
1. Are you currently a caregiver, or have you been one in the past?*

Currently caregivingFormer caregiverBothPrefer not to say
2. Who do/did you provide care for? (Check all that apply)*

Parent or older adultSpouse or partnerChild with health needs or disabilityFriend or neighborOther
3. Roughly how many years have you been caregiving (past or present)?*

Less than 1 year1–3 years4–7 years8+ years
4. What type(s) of caregiver best describes your experience? (Select all that apply)*

Family caregiver (e.g., caring for a parent, spouse, child, or sibling)Friend or community caregiverYoung caregiver (under 25 years old)Working caregiver (juggling employment and caregiving)Long-distance caregiver (supporting someone who lives far away)Sandwich generation caregiver (caring for an older adult and children at the same time)Spousal or partner caregiverParent of a child with disabilities or health needsCaregiver who also lives with a disability or health conditionGrieving or bereaved caregiver (former caregiver who has experienced loss)Prefer not to answerOther
Interests & Availability
5. What types of activities are you most interested in? (Select any)*

Surveys or questionnairesFocus groups or small group discussionsSharing your caregiver story (anonymously or publicly)Helping design caregiver resources (e.g. guides, webinars)Speaking to the media or research partnersI’m open to any opportunities
6. How often would you like to be contacted for input?*

Once every few monthsMonthlyAs needed – I’ll decide each time
7. What’s the best way to reach you?*

EmailPhoneOther
Inclusion & Accessibility (Optional)
8. What region of BC do you live in? (e.g., Vancouver Island, Fraser Valley, Northern BC, etc.)
9. Do you identify as being part of any of the following groups? (Optional – helps us ensure diverse voices)

IndigenousRacialized personNewcomer to Canada2SLGBTQIA+Person with a disabilityPrefer not to answer
10. Do you have any accessibility needs we should know about to support your participation? (e.g., need for interpretation, large print, tech support, etc.)
Your Caregiver Story (Optional)
Would you like to briefly share your caregiver story here? This could be something about who you cared for, what caregiving meant to you, or a moment that stands out. There’s no right or wrong way to share — we just want to hear your voice.
Note: This story will only be used internally unless you give us permission to share it.
Would you be open to FCBC sharing your story (in full or in part)?

Yes, with my nameYes, anonymouslyNo, for internal use onlyPlease contact me before sharing in any way
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FCBC Caregiver Voices Panel – Recruitment Questions

Contact Information

Caregiving Background

Interests & Availability

Inclusion & Accessibility (Optional)

Your Caregiver Story (Optional)