Activist Tool Kit

HEALTH CARE SURVEY PROJECT DESCRIPTION

GOALS OF THE SURVEY ARE TO:

  • Have one-on-one conversations with people around the state, reaching out to new people of all backgrounds (income, race/ethnicity, rural/urban/suburban, age, etc.)

  • Ask people to share personal experiences related to our health care crisis, which can inspire them to take action

  • Expand our list of supporters for future follow-up and leadership development

  • Develop organizers’ skills and confidence in doing outreach and delivering the message of healthcare is a human right, and develop activist relationships in teams

  • Collect leads for health care crisis stories that could be shared in public

  • Compile data and stories in a report to use in advocacy

TEAM PLANNING:

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SURVEY PROJECT PROCEDURE FORM

HEALTH CARE FOR ALL OREGON seeks to engage, educate, and mobilize Oregonians to influence our legislatures to enact HEALTH CARE IS A HUMAN RIGHT. The survey is one of the many tools developed in the strategic plan to be used to facilitate conversations, increase support, and encourage involvement in our campaign to enact universal, comprehensive, affordable health care for ALL.By this means we will invite conversations to discover how Oregonians currently experience their health care.

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Survey

Identifying Our Needs: The Problem

1. Have you ever had problems getting the health care you need? [] YES [] NO

a) What made it difficult to get care? ___________________________________________________

_____________________________________________________

b) Do you have medical insurance? [] YES [] NO

If YES, what type?

[] Through employer [] Medicaid/OHP

[] Medicare

[] Other:________________

2. Have you ever been unable to get the health care you need because of costs?

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SURVEY PROJECT TRACKING REPORT FORM

DATA TO TRACK:

Chapter Name:_______________________________________________________________

Survey Point Person:____________________________________________________________

Month __________ Year______ Number of Surveys being submitted: ____­­­­___

*Has the data entry been completed for local use: Y or N

*Has the data already been submitted electronically to the statewide organization: Y or N

Organization’s target goal by February 4, 2013: ________

Number of surveys organization has collected to date: ___________

Goal for next month?__________

ASSESSING THE HANDLING OF THE SURVEY PROCESS:

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