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Please find the HCAN Statement of Common Purpose and the Small Business United for Health Care 4 C’s on the back of this page.By signing this document, your group will be joining both the national and state effort to win Quality, Affordable Health Care for All.
Business Name: ____________________________ Business Type:________________________Business Owner: ________________________________________________________________ Address: ________________________________City: __________________ Zip: ___________Phone: __________________________________Email: ________________________________ Website: __________________________________________________ No. of Employees: _____ Are you willing to share your perspective on health care with the media? yes / no
 Are you with us for a guarantee ofquality, affordable health care for all?
• We need coverage that meets our families’ health care needsand is affordable, based on a sliding scale.• We need government to be an advocate for us - to set and enforce the rules so insurancecompanies put our health care before their profits.• We need to be able to keep the health care that we have and have the choice of a publicplan so we’re not left at the mercy of the same private insurance companies that have gottenus into this mess.
• We need quality, affordable health care we all can count on.
Health Care for America NOW (HCAN)
is anational grassroots campaign organizing millionsof Americans to win a guarantee of quality,affordable health care for all. We’re bringingtogether community organizers, nurses, doctors,small business owners, faith-based groups,organizations of people of color, students, seniorsand many more who believe it’s time we have asystem that provides quality, affordable health carefor every person in America. We inviteorganizations who support our Statement ofCommon Purpose and our passion for winninghealth care justice in America to join the campaign.
Small Businesses United for Health Care
.Small businesses are the backbone of New York’seconomy, and the heart of communities across ourstate. We create jobs, deliver essential goods andservices, and build strong communities. But ourcurrent health care system is not serving smallbusinesses. We stand for comprehensive healthreform that achieves the “4 C’s”
 www.hcanny.org
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