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* 1. Name

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* 2. Email Address

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* 3. Telephone

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* 4. What is your Medical Profession

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* 5. What PNW community are you looking for accommodations in?

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* 6. What community are you seeking accommodations in?

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* 7. What type of accommodation are you seeking? Click all that apply.

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* 8. Do you require a pet-friendly accommodation?

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* 9. Are you the only person in your party?

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* 10. Do you require parking or will you be relying on public transit?

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* 11. Rental amount (please provide your weekly/monthly rental budget amount with any relevant requests in regard to utilities, wifi, etc)

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* 12. Please provide estimated dates that you are seeking accommodation for.  Include start and end dates.

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* 13. Do you have any special interests, hobbies, or activities that you would like more information about relevant to the community of your choice?

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