Patient Advocates

... to help one another


Dear Members and Friends of UUFCC.

    The Patient Advocate Committee has been formed so that you will not have to confront medical situations alone. Even if a family member or friend is present, a Patient Advocate can often be of assistance in listening to your concerns and working to communicate them through appropriate channels. On a doctor visit, in a hospital, or during home health care, an extra set of eyes and ears can provide you support. Patient Advocate volunteers will make every effort to maximize your comfort level, enhance communication, and ensure appropriateness of care, all the while maintaining confidentiality.

    If you cannot imagine a time when you might need help, please look at the attached scenario sheet. These situations are examples of when a Patient Advocate might be appropriate for you. If after reading it you think it's a good idea, please fill out the survey, also attached, so that your emergency contact information can be entered and held secure, to be utilized only when you request it. Hand it to Herb Levin Chair of the Committee. A poster is on display in the Social Hall, with pamphlets explaining further the function of Patient Advocates. Please look for it, and don't hesitate to speak with an Advocate, identified by his/her badge.

Herb Levin 

Chair of the Patient Advocate Committee

Scenarios where a patient advocate might be useful……

1.  You live alone. You have no family nearby.  You have been taken to the emergency room.  Your best friend is out of town.

2.  You live with your spouse/best friend. You are both in an accident, and hospitalized.

3.  You are a patient in the hospital, alone, and were okay until the drugs kicked in, and you ceased to understand the doctor’s information/instructions.  

4.  You are with your hospitalized spouse/significant other, but must leave to run an errand. You don’t want to leave him/her unaccompanied.

5.  You are feeling nervous about an upcoming medical visit, and would like someone to accompany you and take notes.

6.  You have gone to a medical visit, and have forms to fill out, but you do not fully understand the content. You want someone to help get a fuller explanation.

7. You need someone to call family members for you to explain your medical status.

8.  You live alone, and a home health care representative will be coming. You want a third party present in case you don’t understand everything.

9.  You are going to be admitted/transferred to rehab, or hospice, and have no support system in place.

10.  You need someone to write down your thoughts during a time of medical service.



For a printable copy  Click Here       Patient Advocate Interest Survey        see example below

                                     Patient Advocacy Interest Survey 3/14/14

The Patient Advocates committee is aware that many ot the oongregants of UUFCC live in or visit our area at
some distance from family members and/or the person who is their personal medical proxy.

Patient Advocates offer a number of services tor people who are alone, without support or who may need extra
support even if their family lives nearby. lt you are interested in learning more about or obtaining assistance from
a patient advocate, please till in the following infomation and return this form to Patient Advocacy chairs: Herb

Would you be interested in any of the following services? Please Mark         YES    (X)   or  NO   (X) 

I would like to hear more about the services offered by Patient Advocates     YES  ____      NO  ____

I need the service of an advocate at this time . . . . . . . . . . . . . . . . . . . . . . .    YES  ____      NO  ____

I might want a patient advocate sometime in the future . . . . . . . . . . . . . . .     YES  ____      NO  ____

| consent and give below my emergency contact infomation to be utilized in the event of a medicalemergency.
(Note: all infomation you give will be kept in the strictest confidence to be shared only by The Minister,
the Patient Advocate Chairperson and an Advocate of your choosing)

YOUR NAME:  ___________________________________________

YOUR PHONE #:  __________________________ 

YOUR EMAIL if applicable: __________________________

Primary Emerqencv Contact:

THEIR NAME: ________________________________       Relationship to you: __________________

PHONE NUMBER: ____________________________

CELL PHONE: _______________________________

EMAIL: _____________________________________

Secondary Emeroency Contact:

THEIR NAME: _______________________________         Relationship to you: ___________________

PHONE NUMBER: ___________________________

CELL PHONE: ______________________________

EMAIL: ____________________________________

                                                                                Signature: ________________________________

                                                                                           Date: _________________________________


Patient Advocates are prepared to assist in the following ways:

     1.    Being with a person for important doctor visits.

    2.    Meeting a person at the ER and staying with you through the process of admission / discharge.
    3.    Seeing that the person is well cared for when hospitalized, in rehab, or in a long term care facility.

    4.    Reviewing with the person treatment options offered.

    5.    Helping the person to understand and remember pre-op and post-op instructions.

    6.    Assisting in arrangements for home health care.

Offering forms for living will and end of life directives.

    8.    Helping the person to deal with health related financial issues.


Registry of Patient Advocates, March 2014

RESIDENT ADVOCATES                                           SEASONAL ADVOCATES

Herb Levin    (941) 286-7939  (Cell)  Chair                 Lorrie Douglas  (734) 846-0448      

Tom Deuley   (915) 276-1314                                      Jackie Williamson (734) 846-5323

Dennis Shaw   (941) 830-0848

Joan Bollinger    (941) 286-7297

Carolyn Kellar   (941) 204-8127

If you would like the help of a Patient Advocate, please call someone on this Registry.  He or she will discuss your needs with you.

If for whatever reason, one is not in a position to help, another Advocate will be suggested. 

You've got a friend