We Want to Hear From You! Are you a Medicaid recipient in North Carolina?*YesNoWhat is your date of birth?* Do you have children who are also recipients of Medicaid?*YesNoAs a Medicaid recipient, have you struggled to find doctors/health care professionals that accept your medical insurance?*YesNoApproximately how long does it take you see a doctor from the time you make the appointment to the time you're seen in the office?*Any other comments or concerns you would like to share:Name* First Last Phone*Email* At Civitas, we are interested in learning more about your story. Can we contact you to learn more about your experience?*YesNoPhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle AJAX powered Gravity Forms.