JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Community Conversations 2022 Follow-Up
Thank you for participating in
Health Equity Solutions' 2022 Community Conversations
! We truly appreciate your feedback and sharing your input on what Connecticut residents see as the highest priorities for health equity in Connecticut.
Please share your thoughts on these solutions and how they can be improved to serve you and your community.
Questions? Contact: Harley Webley at hwebley@hesct.org
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Your full name
Your answer
Which of these solutions seem most likely to impact your or (
your family/community/constituents
) ability to access qualit
y
health care? Select all that apply.
*
Ensure sustainable reimbursement for community health workers
Ensure sustainable reimbursement for Doulas
Ensure easy enrollment options on Access Health CT to reduce gaps in insurance coverage
None of the above
Other:
Required
How can the solutions above be improved or modified to ensure you (
your family/community/constituents
) have the ability to access health care services?
*
Your answer
Which of these solutions seem most likely to impact your or (
your family/community/constituents
) ability to afford health care services? Select all that apply.
*
Reduce the impact of medical debt by simplifying and strengthening hospital financial assistance policies
Expand access to Medicaid to all immigrants living in lower income households
Increase access to Covered Connecticut to ensure more people have free health insurance
None of the above
Other:
Required
How can the solutions above be improved or modified to ensure you (
your family/community/constituents
) have the ability to afford health care services?
*
Your answer
Are there any legislative priorities not mentioned in this survey that you are interested that HES should be aware of?
Your answer
Would you like to take part in a larger conversation to discuss your own solutions and share how you think the solutions above can be improved?
*
Yes
No
Would you like to learn more about the solutions shared above and receive regular updates from Health Equity Solutions?
*
Yes
No
Is there anything else that you would like to share with Health Equity Solutions?
Your answer
Please share your email address so we can keep in touch with you! We ask for these details so we can contact you if we have any questions about your responses.
Your answer
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
Forms