2022 Events Survey
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Name
First Name
Last Name
Email
example@example.com
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Suggested Events
Coffee Morning
Afternoon Tea
Evening Meal
Dietician Event
Young Persons Event (e.g., Christmas Party/Summer Picnic)
Newly Diagnosed Event (One to One or Small Group Event)
Other (Please add further ideas in the box below)
Other suggestions - If appropriate suggest venues within the North Hampshire area
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Day of week and Time Availability (obviously Coffee morning/Afternoon Tea are set times of day and the dietician event depends on the availability of the dietician)
Morning
Afternoon
Evening
Any
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Other combination of availability
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Attendance - Face to Face or, Online
Face to face
Online
Both
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Should be Empty: