"Long-Term Care Compact" Legislation - Public Hearing Reply Form

Respond by Tuesday, November 28
Mail to: Assembly Committee on Aging
824 Legislative Office Building
Albany, NY 12248
Or fax to: 518-455-5795


box I plan to testify at the Long-Term Care Compact hearing on December 4.

box I plan to attend, but not testify at, the Long-Term Care Compact hearing on December 4.

box

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




NAME:

TITLE:

ORGANIZATION:

ADDRESS:

E-MAIL:

TELEPHONE:

FAX TELEPHONE:
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