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Feedback Form Bright Spaces
This form allows LGBTQ+ community members to provide feedback privately to providers that are listed in the brightspacesnm.org directory.
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What is the name of the provider?
Your answer
What is the feedback you would like to share with the provider? Please share as much detail as your feel comfortable. Describe the circumstances, actions, and harm you felt.
Your answer
When did this incident(s) happen?
Your answer
What would you have liked to have happened instead of what did happen?
Your answer
If there is something the provider could do now that would help you heal or repair the relationship, please list it here.
Your answer
Would you like us to share this feedback anonymously?
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no
Other:
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This form was created inside of Health Equity Alliance for LGBTQ+ New Mexicans.
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