1. The Health Care Reforms: Nov 27th, 2012

A presentation about the Health Care Reforms and their effect on individuals and the community.

1. What is your name?

* 2. What is your email address? (just in case there is a change of plans on our side)

3. Your age (optional, for research purposes only)

4. How many guests IN ADDITION to yourself?

5. Department / Program:

6. How did you hear about this event? (Please check all that apply)