Paid Family Caregiving - Interest Survey
Tennessee Disability Coalition, in partnership with Tennessee Justice Center, is looking to recruit family caregivers to be the the voice and face of the campaign to establish a Paid Family Caregiving policy in Tennessee. We realize that everyone has their own comfort level in sharing their story, but we are interested in recruiting all types of advocates. Please fill out the below survey to tell us about your interest in this advocacy!
Name
First Name
Last Name
Email
example@example.com
Are you comfortable sharing your experience as a family caregiver?
Yes
No
If you are uncomfortable sharing your story, is there any way we can provide support to make you feel more comfortable?
If you are comfortable sharing your story, please check the following ways in which you are willing to advocate
Legislative meetings
Legislative testimony (in front of a committee)
Meetings with TennCare
Speaking to and/or in front of media
Writing an opinion piece for a newspaper
Participating in Disability Day on the Hill
Other
How would you rate our focus group today?
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
In what ways could we make the focus group experience easier, better or more accessible?
Do you have anything else to share with us today?
Submit
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