Health Cares About Domestic Violence Day
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1. Health Cares About Domestic Violence Day
1
. Have you ever organized or participated in an event for Domestic Violence Awareness Month (DVAM) and/or Health Cares About Domestic Violence Day (HCADVD Day)?
Have you ever organized or participated in an event for Domestic Violence Awareness Month (DVAM) and/or Health Cares About Domestic Violence Day (HCADVD Day)?
Yes
No
2
. If yes, please describe the event:
If yes, please describe the event:
3
. Will you be organizing an event for DVAM (October) and/or HCADV Day this year (October 12, 2011)?
Will you be organizing an event for DVAM (October) and/or HCADV Day this year (October 12, 2011)?
Yes
No
4
. If yes, please describe your plans:
If yes, please describe your plans:
5
. Thank you for completing this survey! If you would like to receive free samples of our materials, please complete the following:
Thank you for completing this survey! If you would like to receive free samples of our materials, please complete the following:
First and Last Name
Organization
Address
City, State, Zip
Phone
Email
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