Exit Development Survey Intro Question Title * 1. Please enter your contact information. We will not share your information or add you to our mailing list without your consent. Name Company Address City/Town State/Province Email Address Phone Number Question Title * 2. Would you like to receive VIM communications? (Check all that apply.) Yes, please sign me up for your e-newsletters. Yes, please sign me up for your mailed newsletters. No, I do not want to receive any communications. I already receive VIM communications. Question Title * 3. How are you involved with VIM? Donor Volunteer Patient Member of the Central Oregon Community Interested in Supporting VIM Next
