Dental Care Access: Lived Experience Advisory Group

People with lived experience have had trouble receiving dental care. They also have Medicaid experience that can help improve the system. Oral Health Kansas will use your meaningful input to advocate for better oral health of Medicaid-enrolled Kansans.

This form is to create a lived experience group to address the challenges that individuals have when it comes to oral health care. All the information will be kept private and confidential. Please fill out this form if you are interested. A small stipend will be provided for your time. Thank you.

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Do you or anyone in your family have Medicaid? *
First Name
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Last Name
 *
Please let us know which, if any, of the following groups you identify with.

This is part of creating an inclusive environment. 

Please check all that apply*

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Required
Have you ever had difficulty accessing oral health care either in the past or currently?
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Are there any particular issues you are interested in working on as part of the group?
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Contact Information
Address
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City
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Zip Code
 *
What is your preferred method of contact?
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Please provide your email address or phone number if you selected email, phone, or text messaging.
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Do you have any access needs or disability accommodations that you would like us to know about?
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If answered "yes" in the previous question, please specify.
What are your preferred days and times that would make it easiest for you to attend our meetings?
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Please specify a time that works best for you.
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