Share your Story with the Ontario Caregiver Coalition

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Thank you for your interest in the Ontario Caregiver Coalition.

We are advocating for better supports for caregivers, because caregivers need change. Specifically, our priorities are advocating for better home and respite care, more autonomy to direct care, and better financial supports for caregivers. These priorities have been determined by our members and by those who have participated in past surveys.

We know you don't have a ton of free time, so we'll be direct: We want to lift up your voice and advocate on your behalf. To do that, we need your story, so we can show our political leaders why they need to make you a priority.

We will only use your contact information if you consent to allowing us to follow up on your story, to joining our email list (our newsletters go out no more than once a month) or to joining as a member of the organization.

If you have any questions, please feel free to contact us at ontariocaregivercoalitionocc@gmail.com.

Are you or have you been an unpaid caregiver for a family member or loved one?

Yes

Prefer not to disclose

Other:

Clear selection

Can you tell us about your experience as a caregiver?

Are you or have you been an unpaid caregiver during the COVID-19 pandemic?

Yes

Prefer not to disclose

Other:

Clear selection

How has the COVID-19 pandemic impacted your experience as a caregiver?

What supports would you like from the government to help you as a caregiver?

Financial Support

Better Access to Home Care

Better Access to Respite Care

The ability to self-direct or self-manage the care from health professionals

Other:

Can you tell us about why these supports would help you? What would they allow you to do that you wouldn't be able to otherwise?

Is there anything else you would like to tell us about advocating for you?

Do we have your consent to share your story in our advocacy efforts, which may include social media posts, communications, and meetings with decision-makers?

Yes

Maybe, I would need to know more

Clear selection

Can we contact you to get more information about your story?

Yes

Maybe, I would need to know more

Clear selection

Would you be willing to tell your story publicly?

Yes, I'd be willing to share my story in a meeting or in an interview

Yes, for the Ontario Caregiver Coalition to share, with my consent, in a pre-recorded video

Maybe, but I would need to know more

No, but the Ontario Caregiver Coalition can share what I've written

No, please do not share my story

Other:

Do you want to hear more about the work the Ontario Caregiver Coalition and its members are doing through our newsletter?

Yes

Clear selection

Do you want to join the Ontario Caregiver Coalition? It's free for caregivers to join.

Yes, I would like someone to get in contact with me about joining.

No, not at this time

Maybe, I need more information

Other:

Clear selection

Name

Phone Number

Email address

Thank you!

Thank you very much for your time. We hope we can lift up your voice and get you the change you need to make your life better during these challenging times.

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