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* 1. Do you work in the health care industry?

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* 2. If yes, what is your specialty?

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* 3. Do you feel black patients are treated differently than white patients?  If so, please explain.

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* 4. What questions do you have for the panelists who will discuss racism in healthcare on September 18th?

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* 5. Have you personally experienced racism as a healthcare provider or patient?  If so, how did it make you feel?

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* 6. Do you plan to attend the Asheville African American Health webinar sessions?

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* 7. Do you have any other comments, questions, or concerns?

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* 8. Would you like to receive updates about the event?

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