Eligibility Screener

Eligibility Screener

Thank you for your interest in Health Chat! To get started, we have a few questions for you. These questions should take less than 5 minutes to answer.

Eligibility Screener Form
1. Are you the mom of a daughter between the ages of 14 and 17?
Yes    No 
2. Does your daughter live with you in your home the majority of the time?
Yes    No 
3. Are you a Tennessee resident?
Yes    No 
4. Do you currently have a Facebook account that you log into at least once a week?
Yes    No