Reader Survey/Information Request
 
Help Us Help You. Get Info From Advertisers. Win A Prize
Fill out and submit the form below
 
How long have you used the directory?
It's My first issue 2-4 years Longer Don't know
How did you find out about it?
 Friends/family Saw it From a Professional Internet
Where do you get copies?
Lawyer/Doctor's office Hospital Home Health Worker
Library Other (please specify)  
 
Did you
use the directory to find...
contact
advertiser?

Buy?
use the directory to find...
contact advertiser?

Buy?
Ambulance/transportation Legal Services
Counseling Medical Care
Education Moving Services
Job/job training Nursing Home
Financial Services Personal Services
Guardianship Prescriptions
Home Health Real Estate
Living Options Rehabilitaion
Insurance Social Services
Please complete the form to be eligible for prizes!
For more information from our advertisers, please check the reader service numbers of those from whom you'd like to have more information. You will find the number after the advertiser's name in the printed directory or the on-line listings.
32
351
442
1259
5771
5897
  
220
363
430
1611
5772
5900
  
 242
366
442
1617
5791
5907
  
308
410
465
1708
5800
5972
  
319
419
552
4466
5801
5974
  
307
421
706
5644
5804
5981
  
336
430
729
5648
5807
5986
  
347
438
755
5663
5861
5991
  
350
439
1199
5770
5895
 
Please complete the flelds below so that the advertisers of your choice can reach you. To help us serve you better please complete the survey questions above.
 

Name:    

Address: 

City:        State: Zip:

Phone (w/area code): 

Alternate Phone:        

Email Address:          
 
Please contact us by: Phone US Mail Email
 
Our need is
immediate 4-6 Months 6 Months-1 Year Longer/don't know
Inquiry is for
Self/Spouse Parent/Relative Friend/Neighbor Client
 

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