1. How do you prefer to receive health information of interest to you? (check up to 3)
   
 
 
 
 
 
 
 
 
 
 
 
 
 
2. Which health topics are of interest to you? (check all that apply)
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
*E-mail Address
*First Name
*Last Name
*Address
*City
*State
*ZIP
*Phone Number
*Gender Male
Female
*Birthdate (mm/dd/yyyy)
*Are you a UAB employee? Yes
No