State of the Heart Visitor Survey
* Please check all that apply for each question

Why Have You Visited Our Website Today?
	To learn more about what State of the Heart Hospice can do for my Loved one and Myself
	To learn more about Grief Support offered by State of the Heart Hospice
	To request information about Hospice care
	To become a volunteer
	To request a speaker for my organization and/or Social event
Where have you seen State of the Heart Hospice Active in our Community?
	My Local Fair
	My Health Fairs and Events
	My Community Chamber of Commerce Events
	My Local Nursing Homes
	Other Comments and / or suggestions:
Have you heard or seen our Advertisements in your local area?
	My newspaper
	My local radio station
	My telephone book
	I don't remember hearing / seeing any advertisements
	Other Comments and / or suggestions:
How could we better inform your Community?
	Attend more of my local events
	More involvement with my local charities
	I think your involvement is already high
	Other Comments and / or suggestions: