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Falls Prevention Programs - Interest Survey

Falls Prevention Programs - Interest Survey

Please complete the survey below if you would like more information about participating in one of Agape's falls prevention programs - Tai Chi and Matter of Balance. After completing the survey, one of our team members will reach out to you with more information. Completion of this survey does not obligate nor commit you to enroll for either program.
4. Please select the falls prevention program(s) you are interested in.
5. Are you 18 years old or older? *This question is required.
7. Is there a day of the week or a time that works best for you? If so, please check the boxes of your availability. 
8. How did you hear about this program? *This question is required.
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