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1. Default Section
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1
. Which Presidential candidate did you address?
Which Presidential candidate did you address?
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2
. Name of Event/Type of event
Name of Event/Type of event
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3
. Event City and State
Event City and State
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4
. Estimated number in attendance
Estimated number in attendance
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5
. Your Name (First and Last Name)
Your Name (First and Last Name)
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6
. Email address (in case we need more information)
Email address (in case we need more information)
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. Did you ask a question about:
Did you ask a question about:
affordable health care coverage?
reliable/understandable health care coverage?
expanding access to preventive care?
access to quality care regardless of income of pre-existing condition?
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8
. What was the candidate's response?
What was the candidate's response?
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. Please describe any personal story/anecdote that you shared.
Please describe any personal story/anecdote that you shared.
10
. Did you distribute any materials or speak with any reporters? If yes, please list the materials and any names/outlets of any reporters.
Did you distribute any materials or speak with any reporters? If yes, please list the materials and any names/outlets of any reporters.
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