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Franklin Coalition on Opioid Use
This is a voluntary survey to learn a little about our coalition members ahead of the first meeting which will be held on June 30th at 7pm in the Franklin High School Auditorium. The information you provide will help us maximize the potential of this coalition-- we will be able to use your experience and expertise appropriately and create the best materials to help us reach our goals. If you know someone who would be interested in participating and joining the coalition, please feel free to send them this link to sign up:
http://jeffreyroy.us6.list-manage.com/subscribe?u=a03272e278ec395d5f164106a&id=3c0ebf784f
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Name
Your answer
Phone Number
in case we need to reach you with any last minute questions or scheduling changes
Your answer
Tell us a little about yourself. Why are you participating in the coalition and what is your relationship to the issue?
*
are you the parent of an addict? a doctor who specializes in addiction treatment? a concerned neighbor?
Your answer
Do you have questions or comments for us?
Your answer
May we share your answers with other coalition members?
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