CHCA Election Questionnaire

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

Name*
Company/Facility*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Position/Title*
Length of time in Long Term Care*
Office being sought*
Why are you seeking state office with CHCA? (50 words)*
Please state your qualifications for the Board of Directors position you are seeking. (50 Words)*
Please state your experience and accomplishments in the field of aging and long term care. (50 Words)*
Please describe other leadership positions in which you have served. (50 Words)*
How would your regulatory/compliance history contribute to the credibility of CHCA in policy making circles and with the public at large? (50 words)*
Please discuss your long range goals for CHCA and the entire long term care field. (75 words)*

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