Consumer Coalition's Comment Form/Guest Book 

Thank you for visiting the Consumer Coalition for Quality Health Care's web site. Please fill out this form then press the send form button.

Name: 

Organization(If applicable): 

E-mail address: 

Address: 

City: State: Zip:

Phone:

Fax:

Now, only fill out the sections that are of interest to you and then press the send form button.

Tell Us About Your State

Please tell us what is going on in your state concerning managed care (legislation, coalitions or people to contact, etc.):

Receive A Hard Copy of The Quality Imperative

To Receive a Copy of our State Model Legislation, please indicated how you would like to receive it:
E-mail
Mail (Check above to make sure your address is complete) Also, remember to check out our "What's New" Page for the ASCI text of the model legislation which you may download.

Donation

If you would like to make a contribution to the Consumer Coalition for Quality Health Care, please send your check or money order to the Consumer Coalition, 1612 K St., Suite 400, Washington, DC 20006
Thank you. (At this time, contributions to the Consumer Coalition are not tax deductible.))

Comments/Suggestions About this Web Site


 


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