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1. Question: Tell us why you are seeking a Respite Retreat at this time, in 1000 words or less:
1. Input - Point Value: 0

All	90 Days	Last Month	Last 7 Days	Notes
Number of Responses: 1 Average: 0 Median Point Value: 0 Median Response:	No Records	No Records	No Records	Sample Notes For Researcher Records Selected for this range start: 2014-02-26 09:18:08 end: 2014-02-26 09:18:08 o1=0.000 CI-0.000 Increase your sample to: 422

XX1

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2. Question: How urgent is this request?
1. Urgent - Point Value: 0
2. Needed Soon - Point Value: 0
3. Based on Availability - Point Value: 0

All	90 Days	Last Month	Last 7 Days	Notes
Number of Responses: 1 Average: 0 Median Point Value: 0 Median Response:Based on Availability No Answers for this question have been collected. More Results are needed.	No Records	No Records	No Records	o1=0.000 CI-0.000 Increase your sample to: 422

XX2

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3. Question: Do you want your spouse to attend this Retreat with you?
1. Yes - Point Value: 1
2. No - Point Value: 0

All	90 Days	Last Month	Last 7 Days	Notes
Number of Responses: 1 Average: 0 Median Point Value: 0 Median Response:No No Answers for this question have been collected. More Results are needed.	No Records	No Records	No Records	o1=0.000 CI-0.000 Increase your sample to: 422

XX3