Candidate Questionnaire for Statewide Office in CHCA

Name: Colorado Health Care Association
Address: 4100 E. Mississippi Ave. Suite 925, Glendale, CO, 80246
Telephone: 303-861-8228

Candidate Name*
First Last
Organization/Facility*
Organization/Facility Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Candidate Direct Phone Number*
Candidate's Position/Title*
Candidate's Length of Time in Long-Term Care*
Office Being Sought*
Why are you seeking state office with CHCA?*
What are your qualifications for state office within CHCA (particularly the one you are seeking)?*
What are your experiences and accomplishments in the field of aging and long term care?*
Please describe other leadership positions in which you have served.*
Please describe the types of community service in which you have been involved. Provide names and/or organizations and dates of services.*
How would your regulatory/compliance history contribute to the credibility of CHCA in policy making circles and with the public at large?*
Please discuss your long range goals for CHCA and the entire long term care filed*
What do you consider the most important issue facing the frail elderly and disabled in Colorado and the country?*

Doug Farmer
CHCA
4100 E. Mississippi Avenue, Ste. 925
Glendale, CO 80246
Phone: 303-861-8228
dfarmer@cohca.org

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