Nurses' CalCare Patient Protection Pledge
En español aqui

FOR CA ELECTED OFFICIALS AND CANDIDATES (AT ALL LEVELS OF OFFICE)

Please fill out this form to take the first step in affirming the Nurses' CalCare Patient Protection Pledge.

The pledge states:

"I pledge that I will do everything in my power as an elected official and/or candidate to fight for the passage of single-payer guaranteed health care in California, also known as CalCare, including but not limited to coauthoring a CalCare bill*, voting for and advancing CalCare through the legislative process*, publicly advocating for CalCare at events and through mass communications, passing organizational and city council resolutions, organizing my community, promoting CalCare campaign activities, holding educational events, attending rallies, lobbying, etc.

"I stand with the California Nurses Association and the overwhelming majority of Californians who support this crucial legislation to fix our broken health care system. California can lead the way."

*Actions with an asterisk only apply if elected to the legislature

Please see the last question on this form regarding the additional verification that is required to take the pledge.

If you have any questions about the information found here, please email info@medicare4all.org. To see a list of current signers, click here.
Sign in to Google to save your progress. Learn more
Name of pledge signer *
Office/Office Sought *
Current Office (if applicable)
Staff name + title (if you do not have staff, please list your own name) *
Staff mobile # (if you do not have staff, please list your own mobile #) *
Staff email (if you do not have staff, please list your own email) *
URL of the posted pledge verification (can be social media or website): *
Pledge verification: To verify that you have signed the pledge, please include a link in response to the above question that features the pledge language on an official social media account, website OR email a photo of the signer signing a copy of the pledge to info@medicare4all.org. A printable version of the pledge is available here (https://bit.ly/3agSaQV) to physically sign. NOTE: you must submit photo/video verification of the pledge in addition to signing this form. *
Required
Submit
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