2024 Clinic Evaluation

Date

MM

DD

YYYY

Host *

First Name

Last Name

Have you ever attended an RPH clinic before? *

Yes

No

How did you hear about this clinic/lesson? *

Friend

Social Media

Email

Other

Was communication from Robbie Potter clear and easy to understand? *

Yes

No

Would you be interested in future clinics? *

Yes

No

Your Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country