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Share Your Story: Waiver Needs

If you or your loved one are on the waiver waiting list and are over 22 years old, please share your story. Your experiences will help us show Georgia's leaders why 1,217 new waivers are urgently needed.

Note: You can submit more than one survey if needed.
1.Name
2.Is it you or a loved one who needs a waiver?
3.If you selected loved one above, what is their name?
4.How old are you or your loved one?
5.Email
6.Cell Phone Number
7.What city does you or your loved one live?
8.What are the most important reasons you or your loved one needs a waiver?
9.Is there anything else you want to share?
10.Can we share your or your loved one's story to help make the case for why Georgia needs more waivers?(Required.)
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