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CLPNS Survey
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1.
In what town or city do you reside?
(Required.)
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2.
Before starting this survey, how familiar were you with CLPNS?
(Required.)
Not at all
Slightly familiar
Very familiar
I, or someone in my household, is directly involved with CLPNS
3.
If you are familiar with CLPNS, please provide a brief explanation of your connection to the organization.
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4.
Have you heard, read, or seen anything about CLPNS, either in-person or online, recently?
(Required.)
Yes
No
Not sure
5.
If you answered 'yes,' please let us know what.
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6.
Have you heard the CLPNS ads on Rawlco radio stations in the past two months?
(Required.)
Yes
No
Not sure
7.
What is your age?
18 - 24
25 - 34
35 - 54
55 - 64
65 or older
8.
Have you or someone in your immediate family received health care in any of the following settings in Saskatchewan in the past year (choose all that apply)
Long-term care
Surgery
Internal Medicine
Primary Care
Emergency Care
Pediatrics
Home Care
Other (please specify)
9.
If you selected any of the above options, was the care provided provided by a Licensed Practical Nurse (LPN)?
Yes
No
I don't know
10.
If you would like to be entered to win a $50 gift card please provide your name and email address.