Advocate When Your Employer Won't Accommodate
Monday, September 9, 2024 at 7:30 PM EST. Join us as we discuss universal accommodations that are available in the work place.
Full Name:
*
First Name
Last Name
Address: City & State
*
Email Address
*
example@example.com
What gender do you identify with?
*
Male
Female
Non-Binary
What is your Ethnicity?
*
African American
Hispanic
Native American or Other Pacific Islander
Multi-Ethnic
American Indian
Asian
Caucasian
What is your age range?
*
18-25
26-34
35-50
Other
Have you been diagnosed with Crohn's Disease or Ulcerative Colitis (IBD)?
*
Crohn's Disease
Ulcerative Colitis
Neither
Do you know what a Chronic Illness Is?
*
Yes
No
Do you know someone with Inflammatory Bowel Disease (IBD)?
*
Yes
No
Does anyone in your immediate family suffer from IBD or any other chronic disease? (heart disease, cancer, diabetes, kidney disease, etc.)
*
IBD (Crohn's or Ulcerative Colitis)
Heart Disease
Lupus
Cancer
Diabetes
Kidney Disease
Other
None
Multiple Chronic Diseases
Are you a current COGI Member?
*
Yes
No
If no, would you like more information on becoming a member?
Yes
No
If you haven't already, would you like to subscribe to COGI's monthly newsletters?
Yes
No
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