Forum Feedback Form Do you prefer to remain anonymous? Yes No NameYou can leave blank if you elected to remain anonymous. First and Last Name EmailYou can leave blank of you elected to remain anonymous. Enter Email Confirm Email PhoneYou can leave blank of you elected to remain anonymous.Please describe the positive experience(s) you’ve had with employment support/access services in Maine.What aspects were helpful or supportive to you?Please describe any challenges or negative experiences you’ve encountered with employment support/access services.Were there any barriers or difficulties in accessing services?What improvement(s) would you suggest for employment support/access services in your community?This can be related to access, options, or any other aspect.Is there anything else you’d like us to know about your experience(s) or how you can be better supported? Please share here.Feel free to share additional thoughts or feedback.Would you like to be contacted by a member of the outreach team?(Required) Yes. Please reach out to me via email. Yes. Please reach out to me via phone/text. No, thank you. Acknowledgment and Consent(Required)By submitting this form, I acknowledge and agree that the information I provide may be collected, stored, and used by the Consumer Council System of Maine (CCSM) for the purposes of informing and improving its programs, advocacy efforts, and services. I understand that: Any feedback I provide may be shared in aggregate or anonymized form with stakeholders, policymakers, or other relevant parties to support CCSM’s mission. If I choose to share my name or other personal information, CCSM will keep this information confidential and will not disclose it without my explicit consent. I have the right to request the deletion of my personal information or withdraw my consent at any time by contacting the CCSM. By submitting this form, I confirm that I have read and understood this statement and agree to its terms. I agree Δ
