Hello! Thank you for taking the time to complete this survey, which will ask about your preferences for receiving outreach materials from the Office of MaineCare Services. If you have any questions, please contact Sarah Fisher at Sarah.Fisher@maine.gov or 207-624-4096.

Question Title

* 1. Please provide your organization's name.

Question Title

* 2. Please provide your organization's address.

Question Title

* 3. Please provide the appropriate point of contact at your organization for receiving outreach and educational materials from the Office of MaineCare Services (name, phone number, email address). Would you prefer to be contacted by phone or email?

Question Title

* 4. Which of the following Cub Care materials would you be interested in having for your organization? Please select all that apply.

Question Title

* 5. For the option(s) that you chose above, how many of each do you want?

Question Title

* 6. Would you like materials translated into any additional languages?

Question Title

* 7. What is the best way to distribute the material(s) to you?

Question Title

* 8. Are there any additional resources you would find helpful?

0 of 8 answered
 

T