7. First Name *
  8. Last Name *
  9. Phone Number *
  10. City *
  11. Email
  12. Island *
  13. What’s the best way to reach you?
  14. If Other *
  16. What organization do you represent?
  18. We’d love to learn more about you. Is there anything else you would like to share?
  19. Submit
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Interest Form

Mahalo for your interest in joining the Med-QUEST Medicaid Advisory Committee! This group is for representatives from community-based organizations, advocacy groups, Medicaid providers or agencies, QUEST Health Plans, and Hawai‘i state agencies to share valuable insights that will help strengthen Hawai‘i’s Medicaid Program.

We’re looking for representatives who want to make a difference by sharing their mana‘o and ‘ike (thoughts and experiences) with Med-QUEST. Your feedback will help us understand what’s working and what needs improvement to ensure Med-QUEST is responsive, inclusive, and aligned with the needs of Hawai‘i’s communities.

As a committee member, you’ll collaborate with others, participate in virtual meetings, and help communicate what you learn with your organization or community and bring their ideas back to the committee.

Mahalo for your interest. We can’t wait to hear from you!

Contact Information

All questions with " * " are Required Fields

Committee Membership Details

Additional Information

QUESTIONS? Email us at [email protected] | We’re excited to connect with you!