Name of the Organization:
Name of the contact person:
Do you think that The Hook-Up will help health centers reach out to youths?
Is there any information about health centers that you think should not have been included in The Hook-Up ? Please select from the topics below.
What is the ethnic break down of their clients?
How do I become a patient?
How do they protect your confidentiality?
What is the Teen Task Force's point of view?
Would you like the Teen Task Force to consider your health center for inclusion in second edition of The Hook-Up ?
Why would you like your health center to be included in the second edition of The Hook-Up?
Other Comments or Questions?
Note: Submission of this survey does not guarantee that your health center will be included in the second edition, but your comments are greatly appreciated.