PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on Caregiver Support / Respite Services for Caregivers of Older New Yorkers are requested to complete this reply form as soon as possible and mail it to:

Debbie Holland
Legislative Associate
Assembly Committee on Aging
Room 522 - Capitol
Albany, New York 12248
Email: holland@assembly.state.ny.us
Phone: (518) 455-4371
Fax: (518) 455-4693


box I plan to make a public statement at the public hearing on Caregiver Support / Respite Services for the Caregivers of Older New Yorkers on December 5, 2005 at the Long Island State Veterans Home in Stony Brook. My statement will be limited to 10 minutes, and I will answer any questions which may arise. I will provide 10 copies of my prepared statement.

box I plan to make a public statement at the public hearing on Caregiver Support / Respite Services for the Caregivers of Older New Yorkers on December 9, 2005 at 250 Broadway in New York City. My statement will be limited to 10 minutes, and I will answer any questions which may arise. I will provide 10 copies of my prepared statement.

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I will address my remarks to the following subjects:



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I will require assistance and/or handicapped accessibility information. Please specify the type of assistance required:




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