Head and Neck Cancer Awareness Talk with free Screenings - Saturday April 8, 2023
This event is free, we ask that you complete this registration form to let us know you are planning to attend.
Event Timing:
  • 3:00 pm - 4:00 pm - Discussion
  • 4:00 pm - 5:00 pm - Head and Neck Cancer Screenings
Note: if you are unable to attend the discussion part of the event, you are still welcome to come to the screening

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