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?

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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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