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STARFLEET Medical - ASG Report
To be used by ASG's/DASG's to submit their bi-monthly report
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Email
*
Your email
Your Name
*
Your answer
Reporting Period
*
MM
/
DD
/
YYYY
Region
*
Choose
Region 1
Region 2
Region 3
Region 4
Region 5
Region 6
Region 7
Region 8
Region 9
Region 10
Region 11
Region 12
Region 13
Region 15
Region 17
Region 18
Region 19
Region 20
Detail any Medical related activities within your Region
*
Your answer
Regional Medical FB Page Members
*
Your answer
Were you able to post on the Fleet Medical Facebook page on your Region's day?
*
Choose
Yes
No
What was the topic of your Fleet Medical Post?
*
Your answer
A copy of your responses will be emailed to the address you provided.
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