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Registration HeartSmarts FEBRUARY HEART MONTH "ASK THE DOCTOR" COMMUNITY ENGAGEMENT SERIES

COMPLETING THIS FORM REGISTERS PARTICIPANTS FOR ALL EVENTS. ZOOM LINK WILL BE SENT THE DAY OF THE EVENT BY 5PM (EST).

ALL EVENTS BEGIN AT 7PM (EST). 

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* 1. First and Last Name

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* 2. What is today's date?

Date

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* 3. Enter the email address to receive zoom link for event below. Double check the address to ensure it is written correctly.

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* 4. How did you hear about this event?

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