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Community Advisor Application

To serve as a Community Advisor, you are required to reside within the EvergreenHealth Monroe District, which encompasses Snohomish, Monroe, Index, Gold Bar, and Sultan.

If appointed as a Community Advisor, you are expected to:

  • Serve a three-year term.
  • Attend Community Advisor Educational meetings, and share information about EvergreenHealth's services and programs with your community (PTSA, neighborhood, etc.)
  • Complete an annual Conflict of Interest Attestation & Disclosure Statement which states, "I, or a related party (as defined in the Conflict of Interest policy), make the following disclosures regarding a financial interest, arrangement, or affiliation with one or more individuals or entities that could be perceived as a real, apparent or potential conflict of interest."

To apply to the program, please complete and submit this form by Sept. 16, 2022.

Applicants will be scheduled for an in-person interview in October

Applicants will be notified of their acceptance following the December 2022 Board Meeting and will be appointed to the Community Advisors with a term start date of January 1, 2023.

For more information, email sklizza@evergreenhealth.com.