PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on The Geriatric Chemical Dependency Act are requested to complete this reply form as soon as possible and mail it to:

Jennifer Best
Legislative Analyst
Assembly Committee on Aging
Room 522B - Capitol
Albany, New York 12248
Email: bestj@assembly.state.ny.us
Phone: (518) 455-4371
Fax: (518) 455-4693


box I plan to attend the following public hearing on The Geriatric Chemical Dependency Act to be conducted by the Assembly Committees on Aging and Alcoholism and Drug Abuse on September 17th.

box I plan to make a public statement at the hearing. My statement will be limited to 5 minutes, and I will answer any questions which may arise. I will provide 10 copies of my prepared statement.

box I will address my remarks to the following subjects:





box I would like to be added to the Committees mailing list for notices and reports.

box I would like to be removed from the Committees mailing list.

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

box






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