Identifying LGBTQ+ Welcoming Network Providers

Molina is building a filter into our Provider Online Directory that is able to sort for welcoming and affirming providers for our LGBTQ+ members. The filter works the same way as it would when a member is looking for "PCP" or "Pediatrician" or "LGBTQ+ Welcoming" etc.

Please reply to the short questions below to determine whether you would be included in the provider directory filter results.

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* 1. Would you like to be listed on the Provider Online Directory filter results as an LGBTQ+ welcoming provider?

Yes

No

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* 2. What is your level of experience or training in serving members who identify as LGBTQ+?

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* 3. Provider Name

First name

Last name

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* 4. Provider Location

Address

City

Zip Code

County

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* 5. Provider NPI

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* 6. Provider Email Address

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* 7. Comments