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* 1. Select from the following list what BEST reflects the sector you represent. Pick one answer only.

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* 2. Please select the field that best categorizes your level of involvement with the coalition.  Please select one answer.

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* 3. Does the coalition have a wide base of membership? Please select one answer.

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* 4. Are we missing representation from any particular sector/group in our community?

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* 5. Please select the statement below that best categorizes your attendance at meetings. Please select one answer.

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* 6. Please select the reasons below that best capture why you attend the meetings.  Select all that apply

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* 7. Please select the reasons that best capture why you rarely or never attend meetings.  Select all that apply

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* 8. Suggestions for meeting improvements

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* 9. Please select from below what you feel are the main functions of the Summit County Opiate & Addiction Task Force.  Please select all that apply

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* 10. Would you like to see the Summit County Opiate and Addiction Task Force include tobacco and other substances?

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* 11. What would you like to get out of task force meetings?

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* 12. Do you serve on a subcommittee?

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* 13. If you serve on a subcommittee please pick the one you serve on.  Please select all that apply.

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* 14. If you wish to serve on a subcommittee, please pick the one you wish to serve on. You may select more than one.

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* 15. How did you learn about the coalition?  Please select all that apply.

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