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* 1. Name

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* 2. Agency

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* 3. What Meeting Frequency would you prefer for the Committee?

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* 4. Location of meeting?

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* 5. Meeting duration:

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* 6. Please rank your interest in the following topics. Use the up and down arrows to put your preferred topics at the top, and those you think are less relevant to the bottom.

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* 7. Other topics of interest in community paramedicine:

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* 8. Other topics of interest for the GMVEMSC Research Committee besides community paramedicine?

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* 9. Other comments and suggestions:

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