Community Health Assessment Workgroup

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* 1. Name

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* 2. Phone

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* 3. Email

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* 4. City

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* 5. Are you able to attend at least 8 meetings in 2023 - 2024

Yes

No

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* 6. I would prefer...

Virtual meetings

In person meetings

Hybrid (virtual and in person option)

Thank you for taking the time to complete our short survey. We appreciate your interest and will be in touch soon.