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* 1. Please provide your email address to register. This is where you will receive the weekly Maintain, Don't Gain resources.

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* 2. The information you provide in this survey will be compiled with other participants' information to create aggregate reports about the program. Individual participant email addresses will be used by the San Francisco Health Service System to provide program updates, educational information, and prizes to participants. We will not, in any circumstances, share your personal information with other individuals or organizations without your permission, including public organizations, corporations or individuals, except when applicable by law. We do not sell, communicate or divulge your information to any mailing lists. Do you wish to participate in this program?

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* 3. Which of the following communications led you to register for
Maintain, Don't Gain?

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