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* 1. Name of Hospital

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* 2. In the past 12 months, how often have you parked at this hospital?

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* 3. What time of day have you parked at this hospital?
(check all that apply)

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* 4. What day of the week have you parked at this hospital?

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* 5. If you are at the hospital for the care or support of your child, are you charged a parking fee?

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* 6. On average, how much does parking cost you when you go to this hospital?

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