PUBLIC HEARING REPLY FORM
Persons wishing to present testimony at the public hearing on examining quality assurance of residential programs licensed by OPWDD are requested to complete this reply form as soon as possible and mail it to:
Katie L. Birchenough
Analyst
Assembly Committee on Mental Health, Mental Retardation, and Developmental Disabilities
Room 520 - Capitol
Albany, New York 12248
Email: birchenoughk@assembly.state.ny.us
Phone: (518) 455-4371
Fax: (518) 455-4693
I plan to attend the following public hearing on examining quality assurance of residential programs licensed by OPWDD on:
June 3rd, 2011 (Buffalo)
June 9th, 2011 (Farmingdale)
June 10th, 2011 (New York City)
June 13th, 2011 (Albany)
I plan to make a public statement at the hearing. 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.
I will address my remarks to the following subjects:
I do not plan to attend the public hearings but I am submitting written testimony.
I would like to be added to the Committees' mailing list for notices and reports.
I would like to be removed from the Committees' mailing list.
I will require assistance and/or handicapped accessibility information.
Please specify the type of assistance required:
NAME:
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