2023 UCRF Small Steps Participation Question Title * 1. Will you be participating in the 2023 Small Steps to Success Campaign within your office? Yes No Undecided Question Title * 2. If you are not participating in 2023, please explain why. Question Title * 3. How would you like to access your campaign resources (i.e. patient letter, poster) I will download from website I am not participating Question Title * 4. Please provide your contact information so we can follow-up with you on your Small Steps 2023 progress & results. Name Country Email Address Done