How to increase health insurance coverage in New York State
Public Hearing Reply Form

Please respond by March 5 for the New York City hearing or April 13 for the Rochester hearing.

Mail to: Assembly Committee on Health, Legislative Office Building, Rm. 822, Albany, NY, 12248

Or fax to:
518-455-5939

box I plan to testify at the

[       ] New York City hearing Friday, March 9

[       ]
Rochester hearing Thursday, April 19

box I plan to attend, but not testify at, the

[       ] New York City hearing Friday, March 9

[       ]
Rochester hearing Thursday, April 19


box

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




NAME:

TITLE:

ORGANIZATION:

ADDRESS:

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