Saline County Opioid Impact Community Listening Sessions

Saline County Opioid Impact Community Listening Sessions
Thank you for your interest in attending a Community Listening Session hosted by the Saline County Health Department, in partnership with Wichita State University's Community Engagement Institute. Please fill out the form in entirety so that we can ensure seating and childcare for those who may need it.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Which listening session do you plan on attending?*
Will you require childcare to attend this event?*

YesNo
How many children will you bring?*
Please include the names and ages of the children who will be attending. If you do not plan on bringing children, please type N/A*
Should be Empty: