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Q.1
What did you like most about attending the event?
Q.2
Was there anything you thought that could be done better?
Q.3
How did you hear about Vanderburgh Homeless Connect?
Q.4
Have you previously attended the Homeless Connect Event?
Yes
No
Don't Know
If yes, what services do you remember using before?
Q.5
Are there any services you neeed that were not here today?
Accupuncture Treatment
BMV Onsite
Chiropractic Treatment
Counseling for Adult Probation
Dental
Employment Interviews
Mental Health Assessment
Prescription
Reading Glasses
Veterinary Care for Pets
Wheelchair & Walker Repair
Don't Know
Other:
Q.6
Name
First Name
Last Name
Q.7
Address
Address Line 1
Address Line 2
City
State
Zip Code
Q.8
Phone Number
Phone Number
Q.9
E-mail
Email
Q.10
Armband #
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