Right Care Action Week 2017
This year's Right Care Action Week is a chance for clinicians, community members, students, and patients to come together to discuss, expose, and protest the harms of high health care costs. We're glad to have you with us!
Name (First and Last) *
Your answer
Where are you located? (City, state) *
Your answer
Email address *
Your answer
Phone number *
Your answer
How did you hear about Right Care Action Week 2017?
Will you be organizing an event for Right Care Action Week? *
What type of event are you interested in? *
Required
Is anybody coordinating with you? If so, please list their names here:
Your answer
Digital Event
Right Care Action Week 2017 will culminate in a digital event on October 21st from 12-1pm, in which RCA members from across the country will meet online to discuss what they've learned from RCAW events, and discuss next steps for action!
Will you join us for the digital event on October 21st from 12-1pm *
Right Care Action Week funding
Our goal for Right Care Action Week is to bring more people into the network and movement! We have limited funding available for people hosting Right Care Action Week Events.
If you are interested in funding, how much are you requesting?
What do you hope to use the funding for?
Your answer
If you are interested in funding, please describe in a few sentences how your event will promote the Right Care Alliance and encourage more people to join.
Your answer
Is this the first RCAW event that you have hosted?
If not, how many have you hosted previously?
Your answer
Have you attended a prior RCAW event?
Are you currently member of a Right Care Alliance council or chapter?
Submit
Never submit passwords through Google Forms.
This form was created inside of Lown Institute. Report Abuse - Terms of Service - Additional Terms