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Q2 2026 Member and Family Advisory Council Meeting Pre-Survey
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1.
Please fill in your contact information to secure your RSVP:
(Required.)
Name
Address
City/Town
State/Province
ZIP/Postal Code
Email Address
Phone Number
*
2.
How did you hear about the Member and Family Advisory Council Meeting?
(Required.)
Word Of Mouth
Website
Text Message
Call Center
Other (Please Specify)
*
3.
Do you need translation assistance and if so, what language do you need?
(Required.)
Yes
No
Preferred Language
*
4.
Have you heard of OhioRise and do you have any questions?
(Required.)
Yes
No
Questions
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5.
Have you heard of Humana's Weight Management Coaching Value Added Benefit and do you have any questions?
(Required.)
Yes
No
Questions
