Share your experience
Help show decision-makers where access is failing.
Your experience can help identify provider shortages, insurance barriers, long waitlists, and missing accommodations. You control how your submission may be used.
0 experiences shared so far
Why we are collecting this
Your answers become anonymous, organized evidence of the barriers patients with autism and other special needs face in finding medical and dental care. We bring that evidence to Medicaid agencies, insurers, and lawmakers. It takes about ten minutes.
Your privacy
Your complete response will be stored securely and reviewed only by authorized administrators. Public reports will use anonymous, combined statistics. If you choose to answer the optional story questions and provide consent, only your age, state, and written story will be displayed on the website. Your name, contact information, and all other identifying information will remain private.
Before you begin
- The form takes about ten minutes and can be saved and finished later.
- Please do not include medical records, insurance identification numbers, Social Security numbers, or full dates of birth.
- Nothing is published without the specific permissions you select.
- This form is not for emergencies. In an emergency, call 911.
Step 1 of 6