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* 1. What is your first name?

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* 2. What is your last name?

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* 3. To which of these cities do you live closest?

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* 4. What state do you reside in?

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* 5. What days / times would you attend a free call-in support group? (check all that apply as good times for you) 

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* 6. If you attend an Ohio support group, which one do you normally attend?

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* 7. Do you plan to go back to meetings in person when we start having them again?

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