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Advancing Equity in OHP Healthcare Listening Session - Lane Co
Please answer the following questions to register for our Lane County session.
Thursday, December 5
5:30 - 7:30 p.m. (includes dinner)
Hilyard Community Center
2580 Hilyard St., Eugene, OR 97405
*
1.
Who is attending?
(Required.)
Please enter your first and last name.
2.
If you represent a community agency or clinic that serves OHP members, please include the name of your agency.
*
3.
What is your email address?
(Required.)
4.
What is your phone number?
5.
Number of adults in your party (over age 18)
1
2
3
4
5
6
6.
If you are bringing children, how many will participate in the children's activity?
1
2
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4
5
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7.
Language assistance services are available to you free of charge. Will you or someone in your party need an interpreter at the event?
Spanish
ASL
Other (please specify)
8.
Accommodations for individuals with disabilities are available free of charge. If you or someone in your party will need assistance, please describe your need.
*
9.
Please confirm you will be attending the event.
(Required.)
Thursday, December 5, 5:30 - 7:30 p.m. (includes dinner)
Hilyard Community Center
2580 Hilyard St., Eugene, OR 97405
