Activity Subject * Activity Date * Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm CHF asks that you provide a report on your work as one of our network of representatives. This means we can keep up to date on the progress of your committee, provide you with the advice and assistance you need and keep other representatives and consumers informed of the issues that you are working on.Ideally, you should report to CHF following every meeting, but we understand that it is sometimes difficult to do this or not always necessary, so the timing of your reports is at your discretion. We also understand that this format might not suit you, so please use another format if you prefer. First Name * Last Name * Name Suffix - None -Jr.Sr.IIIIIIVVVIVIIAOAMACOAMMRCNAPSMAM QC Phone Number Email * What committee do you belong to? Organising Body Date of Last Meeting Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year20222023202420252026 Date of Next Meeting Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year20222023202420252026 Publishing options Can this report be published and shared with other consumer representatives about the committee's work? Yes No (CHF's secretariat will consider your report but it will not be made public) What has the committee been discussing or working on? What have the consumer issues been? Outcomes What decisions have been made which will affect or interest CHF or consumers? Achievements Please provide details on any achievements that you would like CHF to know about Has the committee produced any material which CHF or consumers might be interested in contributing to or obtaining copies of? Yes No Materials If yes, what is it? Who do we contact for a copy? Is the committee planning any activities or events which CHF or consumers might be interested in attending or obtaining information about? Yes No If yes, what are the events? Who do we contact for further information? Do you have any concerns with the committee's work or processes? And if so, do you need help addressing them? What can we do to help? What information or support do you need from CHF to help you to prepare for the next meeting? Please attach any documentation that you wish to provide with this report. Files must be less than 20 MB.Allowed file types: jpg jpeg png bmp pdf doc docx odt ppt pptx odp xls xlsx avi mov wav. Please attach any documentation that you wish to provide with this report. Files must be less than 2 MB.Allowed file types: gif jpg jpeg png bmp tif txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods avi mov mp3 ogg wav. Remember that CHF is here to support and assist you, so don't hesitate to call if you need advice or assistance. On submission, your report will be sent to CHF and a copy sent to your email address. Leave this field blank