Screening of "Healing US" RSVP

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in attending the Screening of "Healing US," a compelling new film on the struggle for healthcare justice. Please fill out the invitation form. The event is part of the San Jose State University Transforming Communities Conference. After the screening of the film, there will be a 45-minute panel discussion featuring:

Kenny Ballentine - Director of "Healing US"

Prof. Alissa Shaw - SJSU Faculty, Department of Public Health
Rep. Ash Kalra - State Assembly Member
Dr. Yusra Hussain, MD - Physician for the National Health Program
Ryan Skolnick - California Nurses Association

When: Wednesday, November 8 @ 5:00 pm - 7:00 pm

Where: San Jose State University - Washington Square Hall Room 109

We look forward to seeing you at the event!

Email *

First and Last Name *

Pronouns you use

What languages do you speak?

How did you hear about the program Screening of "Healing US"?

SJSU

Santa Clara County Single Payer Health Care Coaltiion

Facebook

Instagram

Twitter

Friend/Family

Other:

Would you like to join our movement for Health Care Justice?

Yes

Maybe

Clear selection

Is there anything else you would like to share about yourself and/or your interest in this topic?

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms