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* 1. Are you a......................?

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* 2. Where did you receive or pick up the leaflet?

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* 3. Did you read the text of the leaflet

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* 4. What do you think of the amount of information in the leaflet?

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* 5. What do you think of the usefulness of the information?

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* 6. Did you pass on the leaflet to someone else?

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* 7. Is there any additional information you would like included in the leaflet?

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* 8. Any other comments about the leaflet?

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