Community Engagement Request Form | Engage Vancouver Coastal Health

Key contact person (name, role, department)

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Phone number

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Community of care

Select option

Project or initiative name

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Project Definition

Background information about the project/initiative:

What is the project trying to achieve and by when?

What stage are you at in your project?

Planning

Implementation (putting the plan into action)

Reporting

Evaluation

Why do you want to engage individuals/groups for input in this project/initiative?

Stakeholders can include: patients, clients, family members, caregivers, public

What does your project/initiative need to know from impacted individuals and groups?

Maximum 255 characters

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Examples include: written content and graphics, policy, design elements for a development (i.e., colour palette, art, layout of room, outdoor space), how and what services are provided, and more.

10.

In your project/initiative, what decisions are not open to feedback from impacted individuals and groups?

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Examples include: creating new programs, design guidelines, whether the project/initiative will happen, and more.

11.

What do you expect will change or be impacted by an engagement process?

The outcomes you think will be achieved.

12.

Who is the final decision maker(s) for your project/initiative?

13.

When do you (ideally) need to have engagement completed and an engagement findings report to inform your project/initiative?

Our team will work back from this date to determine when we create an engagement plan and implement the plan.

Impacted individuals and groups

14.

Please select who will be most impacted by the decision(s) being made:

15.

Please describe your key impacted individuals and groups.

Examples include: demographic information, barriers to participation, location, and more.

16.

Are there any particularly sensitive or controversial aspects to your project/initiative that we should know about?

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Examples include: controversial topics, previous negative engagement experiences, disagreement between key participants, and more.

17.

How many people do you expect we should hear from during this engagement?

Examples include: mailing list, existing committee, previous engagement(s)

Level of engagement

"Level of engagement" refers to how involved stakeholders (patients, clients, consumers, residents, families, organizations, public) will be in this process as well as their level of influence. All the levels create a "spectrum of involvement".

Visual of the IAP2 spectrum of engagement: left to right there is increasing level of public influence that goes from inform, involve, consult, collaborate, empower. This spectrum is adapted from the International Association for Public Participation (IAP2) and is found in the Ministry of Health's Patient, Family, Caregiver and Public Engagement Framework (2018).

18.

Please indicate below which level(s) of engagement you are seeking. You may select different levels depending on those you have in mind to engage.

Inform - “We want to let stakeholders know about what we are doing and what it means for them.” This is the first part of all engagement processes.

Consult - “We want to let our stakeholders know about what we’re doing and gather their feedback (on a draft), which we’ll then take into consideration in our decision-making.” We are still at a stage where decisions are still being shaped.

Involve - “We want to ensure that we are hearing from our stakeholders before anything is created, so that they are directly reflected in our decision-making throughout the project.” This level of engagement encourages discussion among/with stakeholders.

Collaborate - “We want to bring our stakeholders in as partners in all aspects of the decision(s) to be made throughout the process of this project.” This level of engagement allows for individuals to shape policy and program decisions that affect them.

Empower - “We want our stakeholders to make this decision(s). We will implement what they decide.” This level of engagement asks the stakeholders to be the decision makers.

Other (please specify)