Health Care Story Form

You’re not alone, we’re in this together as a community. CCHI uses stories like yours to help us advocate for the health care changes that represent consumers’ needs and concerns. Your story makes the difference! Statistics matter, but a story can make or break a legislative decision. After filling out this form you will receive a call or email from someone at the Colorado Consumer Health Initiative to talk more about your story. We will work with you to find ways to share your story, always with your permission, to help advocate for health care policies in Colorado.

1. Contact Information

First Name *This question is required.

City

State

Zip

Email Address *This question is required. This question requires a valid email address.

Phone Number *This question is required.

2. Are any of the following true about your story?

I enrolled in a new plan through the Connect for Health Colorado
I am a contract worker or self-employed
I am uninsured
I am an entrepreneur or a small business owner
I have insurance through my workplace
I have lost my coverage due to COVID-19

3. What has been your experience buying health coverage in the marketplace (Connect for Health Colorado)? Do you find it affordable?

3. When you think about your health coverage, what matters most to you?

4. Has the cost of health coverage affected the choices you make about your healthcare or other parts of your life? (Ex. Have you been to the doctor less? Have you avoided going to the hospital or Urgent Care?)

5. Have you encountered high hospital costs or bills?

6. Have you struggled with prescription drug costs or to afford basic needs such as food or utilities due to the cost of your medication/s?

7. If you could say one thing to your representative with regards to health care what would that be?

8. Would you be willing to share your story with policymakers?

9. Do you need or want help navigating an insurance issue or health care bill?