RHEC Requests

Requester Information

Accessibility Statement
OHA welcomes all participants. If you have any questions about accommodations or need any assistance to participate please call or email us at rhecprogram@oha.oregon.gov or 971-219-7445 (voice/text). All relay calls are accepted.

Purpose
Thank you for your interest in Regional Health Equity Coalitions (RHECs)! Please help us understand who you would like to connect with and for what purpose by completing the following questions. This helps ensure all information needed to understand the request is provided and that the Equity and Inclusion (E&I) RHEC team have a way to track and quantify the requests received over time.

1. Name *This question is required.

2. Preferred Gender Pronouns (i.e. they/them, she/her, he/him, etc.)

3. Organization you are associated with *This question is required.

Please enter an 'other' value for this selection.

4. What section, unit, and/or program are you associated with?

4. Website for your organization

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

6. Phone number *This question is required.