CHRISTUS Health | Community Health Needs Assessment Community Survey - Paper Form Request
Please complete the request form below, so we can print and mail your organization the surveys in paper format.
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Email *
Which CHRISTUS hospital or health system do you work closely with? *
What is the name of your organization? *
How many paper copies of the community survey would you like? *
What language would you like the community surveys to be printed out in? *
Who is the contact person to receive the paper survey and their phone number?
What is the address for CHRISTUS to mail the paper surveys to your organization? (Include attention to, street, city, state and zip code) *
A copy of your responses will be emailed to the address you provided.
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