Event Date
*
MM slash DD slash YYYY
Event Number (ex: 12345)
*
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Client
*
Not Listed
Andrews University
Chipotle
Episcopal High School
Mount Saint Mary's University
Lead Staff Name
*
Who was your TotalWellness Account Manager?
*
Paula Wedel
Other
Number of participants
*
Please enter a number from
0
to
9999
.
Were you able to obtain samples from all participants?
*
Yes
No
Did the event start on time?
*
Yes
No
Please provide start time and explanation:
Did the event end on time?
*
Yes
No
Please provide end time and explanation:
Issues that affected the outcome of the event (IE. Missing supplies, staff issues, large number of re-sticks, etc.)
Overall success:
*
Please upload the documents listed below.
Time Log - Page 1
*
Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 50 MB.
Time Log - Page 2
Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 50 MB.
Test Kit Barcode Sheets
*
Max. file size: 50 MB.
Test Kit Barcode Sheets - Page 2
Max. file size: 50 MB.
Test Kit Barcode Sheets - Page 3
Max. file size: 50 MB.
Test Kit Barcode Sheets - Page 4
Max. file size: 50 MB.