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* 1. I live in (name of town or city)

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* 2. I would participate in a health fair if it was held in or near my community

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* 3. What would you like to see offered at the health fair?

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* 4. I would attend a class or series on the following subjects if they were held in or near my community. Please check all that apply

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* 5. Do you have a primary care doctor?

T