Walk with a Doc Post-Event Survey
Thank you for hosting a Walk with a Doc event! Please have your chapter leader complete the survey below after each walk and let us know if there's anything we can do to help support you for the next event!
Sign in to Google to save your progress. Learn more
Email *
Your Name
Chapter Number *
Walk Date *
Please include the full year (ie type 2023 instead of 0023)
Number of Participants *
Including leaders, staff, volunteers, etc.
Speaker/leader for this event
Please include the first name, last name, and credentials of the healthcare provider(s) who gave the health talk at this particular event. e.g. "John Smith, MD"
Health Topic
Please provide any additional feedback: good or bad!
Thanks for completing this survey! After hitting "submit" below, please email contact@walkwithadoc.org or call 614-714-0407 with any questions, website updates, or anything we can do to help support you. We're excited for your next walk!
Clear form
Never submit passwords through Google Forms.
This form was created inside of Walk with a Doc. Report Abuse