Virginia Quality HealthCare Network

VQHN Members Form

Our Mission: Educate and advocate to achieve quality healthcare for all Virginia citizens.

Our Goals:
Ensure access to appropriate and quality treatments and medications

Encourage disclosure of benefits and oppose restrictions on treatments

Support adequate Medicaid funding and insurance coverage

Promote patient rights and responsibilities

Educate Virginians about healthcare access issues

Complete the following information to be updated via email on new developments in the Virginia Quality Healthcare Network and other news that is important to you. Use the TAB button to move between fields.

Organization:
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Contact Information
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Email Address:	Your email address will be your username, should you ever need to update your subscription information.
Organization's Web Site
Alternate Contact Information Yes! I wish to have the alternate receive duplicates of the material that I receive.
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YES! You may list our organization as a member of the Network.
YES! Our organization would be interested in sorting our membership database into Senate and House districts. (Please Contact us if you are interested in this service.)
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Privacy Policy Required Field	Membership Dues Organizations – Total Budget. 0 -$500,000 $25 $500,000 - $1,000,000 $50 over $1,000,000 $100 Individuals $15.00 per year Please forward your check and form to: VQHN 9S 12th Street Suite 300 Richmond, VA 23219