Buddy Check 7 Registration

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Buddy Check 7 Email Alert Registration

Buddy Check 7 is a breast health awareness and early cancer detection program formed by WSAW-TV NewsChannel7 and Marshfield Clinic.

Use this form to join us in our effort and register for our Buddy Check 7 e-mail alert. On the 7th of each month, you'll receive an alert with the latest breast cancer information and a reminder to perform a monthly breast self-exam.

In addition, provide us with information for your "buddy" – a family member, friend or co-worker
and we'll send her an e-mail inviting her to sign up for the monthly reminder, too.

 

1.Email
*
2.First Name
*
3.Last Name
*
4.Street Address, City, State, Zip
5.Contact Number
6.Gender
7.Buddy's First Name
8.Buddy's Last Name
9.Buddy's E-mail
10.Please enter your date of birth.
Month* Day* Year*

11.Terms and Conditions
I have read, understand, and agree to the Website usage agreement and privacy policy.
* represents required fields