Clone of CERP Quiz

1

Question 1 of 6: Can you provide the name of the person you'd like us to connect with?* This field is required.

First Name

Last Name

2

Question 2 of 6: Can you provide the role or title of the person we'll be contacting?* This field is required.This can include PTA/PTO roles

3

Question 3 of 6: Can you provide the email you'd like us to contact for scheduling of our conversation?* This field is required.

example@example.com

Email Verified

The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification

••••

4

Question 4 of 6: Does your school or district have budget set aside for health emergency planning?

YESNO

5

Question 5 of 6: Where is your School or District located?

6

Question 6 of 6: Does your school have a written Cardiac Emergency response Plan (CERP) that outlines step-by-step actions during a cardiac emergency, including designated roles and responsibilities?* This field is required.

YESNO

7

Is there anything else you'd like share with our team before meeting?If not, feel free to skip this question.

8

Please verify that you are human* This field is required.

9

Eastern States Region Account

YESNO

10

Midwest Region Account

YESNO

11

Southeast Region Account

YESNO

12

Southwest Region Account

YESNO

13

Western Region Account

YESNO