This survey is designed to be quick and easy and involve little description.  Each entry that you make represents the work of ONE nurse/health minister.  Please select from dropdown menus.  You DO NOT have to answer every question.  You DO have the option of adding description to each question, but this is not required.  This survey takes about 5 minutes to complete.

Question Title

* 2. Who completed these hours (first and last name)?

Question Title

* 3. What is the name of the community served (may be a faith community, geographic community or other)?

Question Title

* 6. How would you improve this survey?

Question Title

* 7. What type of support or continuing education would you like to receive from HMN?

Question Title

* 8. If you would like a copy of your survey to be sent to you for reporting elsewhere, please include an email address here:  

T