Communities of Faith Mobilizing to Prevent Overdose Question Title * 1. Please provide the following information: Name Organization Organization Mailing Address Address 2 Organization City/Town State/Province Organization ZIP/Postal Code County Participant Email Address Participant Phone Number Question Title * 2. Please identify your organization. This is not an exhaustive list, so if needed, write in your information in other. Baptist Methodist Lutheran Presbyterian Episcopal Catholic COGIC Assembly of God Jewish Muslim Mormon Non-denominational Other (please specify) Question Title * 3. If you have questions you would like answered during the conference, please feel free to add them here. If not, you can ask via the chat on 4/28/22. Question Title * 4. Does your organization have a health ministry/committee Yes No Question Title * 5. If your organization has a health ministry or desires to create one, the Durham County Health Ministry Network is a wonderful resource to start and sustain your efforts. Are you interested in joining or learning more? Yes No My organization is not located in Durham County Question Title * 6. Great! We love that you are interested in the Durham County Health Ministry! Please answer the questions below and we will follow up. Name Email Address Phone Number Done