Story of a Virginian Enrolled in the New Medicaid Health Insurance

Thank you for your willingness to help VHCF gather stories of Virginians benefiting from the new adult Medicaid health insurance! Please complete the form below with information about yourself and your client.

VHCF may follow up with you to learn more about your client and how being enrolled in Medicaid has helped him/her.

Thanks again for your help!

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* 1. How has the New Medicaid health insurance helped your client?

Received medical care

Received dental care

Received behavioral health (mental health) care

Was able to fill prescription(s)

Was able to get well enough to get a job

Was able to increase hours at work due to feeling better

Other (please specify)

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Story of a Virginian Enrolled in the New Medicaid Health Insurance

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* 1. How has the New Medicaid health insurance helped your client?

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* 2. What is your client's name?

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* 3. What is your client's phone number?

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* 4. Where does your client live?

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* 5. What is your name?

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* 6. What agency do you represent/how do know the client?

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* 7. What is the best phone number to reach you during the day?

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* 8. What is your email address?