Advocacy Survey

We appreciate your continued support of Allergy & Asthma Network. The Network’s advocacy function is critical to our mission as we raise awareness and educate policy makers about the importance of smart and effective policies and programs to end the needless death and suffering of the millions of Americans living with asthma, allergies and other related conditions.

To improve our communications and engagement with you, please take a few minutes to complete this brief survey. We would like to learn about your priority interests. Your answers will be kept confidential.

Thank you,

Tonya Winders, CEO and President
Charmayne Anderson, Director of Advocacy

Question Title

* 1. Address

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Please identify issues of interest to you: (Check all that apply)

Asthma/Respiratory

Allergies

Health Insurance

Access to Healthcare

Prescription Drug Cost

Telehealth/Remote Patient Monitoring

School Nurses/Children’s Health

Innovative Therapies (biologics)

Environmental Health/Climate Change

Health Disparities

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* 3. Would you be willing to reach out to policymakers to help educate them about issues identified in Question #10?

Yes

Maybe

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* 4. Please check the option(s) from the menu below to tell us more about they type of action you are willing to take:

Make a phone call

Send a letter

In person meeting (locally or in D.C.)

Write an op-ed piece in local paper

Host or organize a site visit for a Member of Congress or his/her staff

Provide oral/written testimony (Legislative Committees at State / Federal levels)

All of the above

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* 5. Is there anything else that you would like us to know, or do you have any feedback about this survey?

Thank you for taking the time to complete our survey!