BERGER COMMISSION REPORT
Public Hearing Reply Form

Mail to: Assembly Committee on Health, The Capitol, Rm. 522, Albany, NY, 12248
Or fax to: 518-455-4693

I plan to [     ] testify at [     ] attend the


[     ]   Albany (Northern Region) hearing Monday, December 11
[     ]   Buffalo (Western Region) hearing Monday, December 11
[     ]   Syracuse (Central Region) hearing Monday, December 11
[     ]   White Plains (Hudson Valley - Westchester) hearing Monday, December 11
[     ]   Kingston (Hudson Valley - other than Westchester) hearing Monday, December 11
[     ]   Long Island (Long Island Region) hearing Monday, December 11
[     ]   New York City (New York City Region) hearing Monday, December 11

[     ]   

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


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