Response Form

Thank you for your support of the Heart Health Partnership Health Promotion and Disease Prevention Campaign. We are compiling the results of this effort and ask for your feedback on any activities you may have undertaken in your area. Could you please take a few moments now to answer the following questions, and return this form by fax to (902) 494-1916 or e-mail  by January 15, 2000. Feel free to share success stories you have discussed with your MLA and media representatives. You can also access a printable version of this form.

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Please place a check beside any of these advocacy efforts you were able to undertake in your area.
Issue a Letter to the Editor of the local newspaper
Attend public consultations for the Provincial Health Council, Core Health Services
Place a phone call to your local MLA
Schedule a meeting with one or more of your local MLAs
Send a letter to a member of the political parties
Please note any other advocacy efforts you may have initiated:

Please note any responses you received from your MLA or decision makers in your community:

Did you find the communication/support materials distributed to you useful?
Yes...If yes, why? 

No...If no, what other materials or adaptations of the materials sent, would have been more useful?

Is there a particular issue you feel has not been addressed?
Yes, a concern of mine is: 

I would find value in having these additional support materials developed:

Other Comments:

Thank you for your time and support!