Monthly Stats Report 

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* 1. Your Name: 

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* 2. Name of workgroup/caucus 

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* 3. workgroup/caucus met via? (select as many as needed)

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* 4. Date of meeting

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* 5. How many people attended and what is their role? Please list in the following format: ex.) 17 advocates; 5 hospital staff; 3 community members

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* 6. Any additional comments:

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