Chambers Area WHMS Mobile Clinic Survey Question Title * 1. What day of the week would you most like to see the mobile clinic in town to see patients? Monday Tuesday Wednesday Other (please specify) Question Title * 2. What services do you think would be the most useful to the community? Wellness Exams Sick Visits Sports Physicals Vaccine Clinics Other (please specify) Question Title * 3. What locations or events would you most like to a see a mobile clinic at? Question Title * 4. We want this mobile clinic to help Chambers! Do you have any other suggestions for ways it could be used to benefit the community? Question Title * 5. We will draw for a giveaway prize from our survey responses! Please fill out this question if you would like to be eligible! Name Phone Number Done