Complete the survey for a chance to win a TV wall mount kit!

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* 1. As a reader, what is your relationship to children?  (Check all that apply)

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* 2. Please select all the ages of children you have and/or work with?

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* 3. What is your highest grade level completed?

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* 4. Define where you live:

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* 5. What resources do you use or go to for educational material on preventing childhood injuries?  (Select all that apply)

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* 6. Does your child's healthcare provider discuss ways to prevent childhood injuries?

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* 7. Where did you pick up your Greater Valley Guide?  (Please put the name of the location in the "other" section)

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* 8. What injury prevention area (s) would you like to see more information on? (Select all that apply)

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* 9. Would you like to be entered for a chance to win a TV wall mount kit?  If yes, please leave a contact phone# as a comment under "Other"

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