Laboratory Tour Feedback Form

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* 1. Was this the first laboratory tour you ever organized?

Yes

No

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* 2. What was the name of the legislator and/or staff you met with?

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* 3. Please provide a summary of the discussion:

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* 4. What was the date the lab tour took place?

Date / Time

Date

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* 5. Do you have any pictures you would like to submit to CAP staff to feature you in the PathNET newsletter or the CAP's Advocacy update?

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* 6. Is any follow up from CAP staff necessary?

No

If yes, please specify on what issue(s):

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* 7. Are there things the CAP can do to help you prepare for the laboratory more? Are there things that worked well?

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* 8. How likely are you to host another laboratory tour in the future?

Unlikely

Very likely

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 9. Please provide us with your contact information

Name

Company

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Mobile Number