340B Advocacy Participation Form Thank you for taking part in HealthNet’s advocacy efforts to oppose the Indiana State Medicaid Plan Amendment and protect 340B for community health centers. Please complete this form after taking action—your response helps us track participation in real time. Question Title * 1. Did you participate in HealthNet's 340B Advocacy by submitting a comment to the Indiana Family & Social Services Administration about the proposed Medicaid State Plan Amendment? Yes No Question Title * 2. What is your primary HealthNet work location? Barrington Health & Dental Center Bloomington Health Center Downtown Health Center Martindale-Brightwood Health Center Northeast Health Center People's Health & Dental Center Southeast Health & Dental Center Southwest Health & Dental Center Specialty Care at Barrington Speedway Health & Dental Center Healthy Families Homeless Initiative Program Administration Genesis Plaza (Revenue Cycle, HIM, EMR, SHAW, Clinical Education, etc.) School-Based Patient Access Center Triage Other - Board of Directors Volunteer Done