The Coda Jazz Fund

Name:  Email:   Phone:

The CODA Jazz Fund will hold a Health and Financial Fitness Fair on Saturday, October 11, 2008, in conjunction with The American Jazz Museum Salutes Art Blakey. We are conducting a survey to prepare for the fair.

1. Do you have health concerns?
2. Do you have health insurance?
3. Do you have a retirement plan?
4. Do you have a primary care physician?
5. Do you have a financial advisor?
6. Do you get annual or routine health physicals?
            If no, what prevents you from getting routine health care?  
7. Would you attend a Health and Financial Fitness Fair October 11, 2008, 10 am-2 pm?
8. What are your top 3 concerns about your health?  
9. Would you benefit from more financial knowledge regarding taxes, saving
money, or insurance?
10. Do you need transportation to the Health Fair?
11. Please select the Health Screenings and Information (check any or all) you would like to receive on October 11, 2008:
12. Financial (check any or all):
The screenings will last approximately 45 minutes—1 hour. Check time you would prefer to attend the Health and Financial Fitness Fair:
 
 
If you have questions, please call: 816-234-4417
 
WE HOPE TO SEE YOU AT THE FAIR BECAUSE CODA CARES ABOUT YOU.