JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
RBNA Candidate Night 2026
Join the Rochester Black Nurses Association (RBNA) Health Policy Committee for a virtual Candidate Night focused on the policies and decisions that shape the health and well-being of our communities.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
First and Last Name
*
Your answer
How would you describe your connection to this event? Select all that apply.
*
RBNA Member
Nurse or healthcare professional
Nursing/health professions student
Community member
Candidate or elected official
Other:
Required
Which topics are you most interested in hearing discussed during Candidate Night?
Select all that apply
Nursing workforce development, diversity, and health equity
Equity and safety in AI and the nursing workforce
Mental health equity and stigma in Black communities
Black maternal health and maternal mortality
Gun violence as a public health issue
Governmental changes and their impact on health equity
Environmental impacts on health equity in Black communities
What question(s) would you like candidates or elected officials to address?
Your answer
Would you like to receive information about future RBNA Health Policy Committee events or advocacy opportunities?
*
Yes
No
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report