Join the HPV Free COmmunity Advocate Group!
Thank you for your interest in joining the HPV Free COmmunity Advocate Group! This group is part of efforts by the Alliance for HPV Free Colorado, a 15-county collaborative between local public health partners, to improve HPV vaccination rates in our state and protect communities from HPV-associated cancer. As a member of the HPV Free COmmunity Advocate Group, you can choose to participate in HPV advocacy in whichever ways work best for you. We will provide information, training, and a lot of support to all of our parents that participate in advocacy activities--we’re with you each step of the way. Welcome!
Email address *
First Name *
Your answer
Last Name *
Your answer
City *
Your answer
County *
Your answer
Phone Number
Your answer
What is your personal relationship to HPV or the HPV vaccine (if any)?
Your answer
Which community groups or organizations involved in cancer prevention, HPV, or vaccines are you part of (if any)?
Your answer
Tell us about yourself and why you're interested in advocating for the HPV vaccine in your community. *
Your answer
I am a parent of (select all that apply): *
I might be interested in (select all that apply): *
Required
What other groups or activities (not related to vaccines or HPV) do you and/or your family participate in in your community? Please specify which groups in particular in the "other" section. *
Required
What is the best way to contact you?
Do we have your permission to add you to our email list? (This list allows us to let advocates know when there are upcoming advocacy opportunities.)
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service