Doctors' Day - Share Your Story
Share your story below by March 11 to ensure your provider receives your note of appreciation by National Doctors' Day.
1. Please provide your first and last name:
First Name
Last Name
2. What is your phone number?
Please enter a valid phone number.
Format: (000) 000-0000.
3. What is your email?
example@example.com
7. Please share your story below on how a Tri-State Memorial Hospital provider has shown you or a loved one the highest quality of care:
*
Authorization (Please check all that apply)
*
I authorize Tri-State Marketing & Communications to contact me regarding my Doctors' Day testimonial.
I authorize Tri-State Marketing & Communications to share my Doctors' Day testimonial on Tri-State Memorial Hospital's social media page.
I authorize Tri-State Marketing & Communications to include my name when they share my Doctors' Day testimonial on Tri-State Memorial Hospital's social media page.
I would like to be added to Tri-State Memorial Hospital's email list to receive messages regarding hospital changes, updates, service lines, provider information, or general marketing communications.
None of the above.
Please sign below to authorize all of the above checked boxes.
Submit
Should be Empty: