Living with Disability & Chronic Illness — Affinity Group Feedback
Collecting info on disabled staff experiences at Health Care for the Homeless. 
All questions are optional and you can choose to remain anonymous! 

Reach out to rritter@hchmd.org with any questions or to get involved.
Sign in to Google to save your progress. Learn more
Name (not required):
Email address (not required):
Job title/department (not required):
If you're interested in attending meetings, what would work the best for you? (Check all that apply)
Are you interested in a leadership position with the Affinity Group?
Clear selection
Do you identify as disabled?
Clear selection
Do you talk about your disability at work?
Do you think your coworkers have a good understanding of disability and ableism?
Have you requested accommodations at work? If so, what was your experience like? 
What do you want to see from this group? 
If you think changes are needed to support disabled people in our workplace, what issues are the most pressing?
Any questions? Anything we missed/messed up on? Anything else you want to share about disability at Health Care for the Homeless? 

Let us know, and thank you for sharing! 
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy