Colorado Dementia Care Partner Advisory Panel Interest Form

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Thank you for your interest in participating in our Colorado Alzheimer's Disease and Related Dementias (ADRD) Care Partner Advisory Panel! Please complete the form below and someone will contact you with more information about participation.

Who can participate? Any Coloradan who identifies as a care partner (a friend or family member who provides care or support) for a loved one with Alzheimer's Disease or another form of dementia.

What are the goals of participation? To share your experiences navigating diagnosis, care, and life as a care partner, to provide input on activities related to the implementation of Colorado's ADRD State Plan.

What does participation look like? This advisory board convenes quarterly, meetings will be held virtually via Zoom. The next meeting date and time are still TBD . Compensation is available.

For more information about the ADRD Action Coalition, or Colorado ADRD State Plan, please visit our Get Involved page here, or contact Joanna Espinoza Robbins, ADRD Program Manager, at joanna.espinozarobbins@state.co.us

CDPHE Accessibility Statement and Support

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E-Mail-Adresse *

Name *

We are seeking diverse representation from throughout the state, please provide the zip code or county you reside in: *

What type of dementia is your loved one experiencing?

Select one or more race categories:

American Indian/Alaska Native Alone

Asian Alone

Black/African American Alone

Native Hawaiian/Pacific Islander Alone,

White Alone