Welcome!

Welcome to the Time to Talk registration page! We are very excited to have you participate in the Time to Talk campaign. We look forward to hearing from you!

Please provide us with your name

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* 1. Please provide us with your name

Please provide us with your contact information

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* 2. Please provide us with your contact information

What faith community do you represent?

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* 3. What faith community do you represent?

What is the name of your place of worship?

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* 4. What is the name of your place of worship?

When will you be speaking to your faith community about health and end-of-life care wishes, values and beliefs?

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* 5. When will you be speaking to your faith community about health and end-of-life care wishes, values and beliefs?

How many people usually attend your faith gathering?

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* 6. How many people usually attend your faith gathering?

Please tell us more about your event

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* 7. Please tell us more about your event

Would you like free Advance Care Planning resources to offer your community?

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* 8. Would you like free Advance Care Planning resources to offer your community?

Can we follow up with you afterwards to hear how Time to Talk went?

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* 9. Can we follow up with you afterwards to hear how Time to Talk went?

How did you hear about Time to Talk?

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* 10. How did you hear about Time to Talk?

Do you have any questions or comments for us?

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* 11. Do you have any questions or comments for us?

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