CAC Policy & Advocacy Committee Interest Form
Are you interested in joining our newly formed policy and advocacy committee? We would love to have you, so please fill out the form below!
The goal of this committee is to support the effort of the Board of Directors through policy, advocacy, and storytelling. To this end, the Committee will:
  • Monitor and share out local, state, and federal policy and advocacy opportunities related to asthma and lung health
  • Collect, prepare, and share patient, family, and provider stories to inform and influence policy
  • Identify and provide education and training to CAC members, patients, family/caregivers, and providers to strengthen advocacy capacity
  • Recommend policy and advocacy actions to the Board for approval and execution
Name *
Email *
Phone number
Profession/Role *
e.g., nurse, parent, researcher, etc.
Please describe any prior advocacy work, if any *
It's okay if you don't have any experience! If that's the case, please just write "NA"
Why do you want to join this committee? *
What's the best day for an afternoon launch meeting?  *
We are thinking of having our first meeting in March (before spring break)
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

Google Forms