PHIP Focus Groups RSVP 

Please complete this form to indicate which focus group you're interested in participating in.

The Walsenburg focus group has been cancelled. Email mc.brown@onehealthinsights.com with any questions.

Trinidad 
Date: Tuesday, May 7th
Time: 9:30am - 11:30am
Location: Trinidad Community Center - 1309 Beshoar Avenue, Trinidad, CO 81082

Gardner
Date: Wednesday, May 8th
Time: 5:30pm - 7:30pm
Location: Gardner Community Center - 28 Co Rd 632, Gardner, CO 81040

Refreshments will be provided and all attendees will be entered to win a $50 Gift Card!


Questions? Contact Mary Carson Brown at mc.brown@onehealthinsights.com

Sign in to Google to save your progress. Learn more
Which focus group would you like to participate in?  *
Contact Information
Please include your contact information below. The information you provide will only be used to contact you regarding the focus group and will not be shared or associated with this project. 
Name
*
Email Address *
Phone Number *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of One Health Insights, LLC. Report Abuse