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The Physician Advocacy Liaison Network
The purpose of the Physician Advocacy Liaison (PAL) Network is to get MSSNY and the physician community’s message across in a more visible way at the local level. The PAL network will help to make grassroots contacts with legislators more defined and personal. At least two or three members will be assigned as a liaison to each state legislator. The member will be a constituent of the legislator they are assigned. These PALs will meet personally with their assigned legislator at least twice a year to develop close relationships with elected officials.
First Name *
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Middle Initial
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Last Name *
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MD/DO/Etc. *
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Street Address (Voting Address) *
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Town/City *
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Zip Code *
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Email *
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Phone Number (xxx-xxx-xxxx) *
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County *
Speciality *
Are you a PAC Member? *
If you are a PAC member, would you like to be a PAC Champion? *
Are you a Medical Student? *
Do you already have close relationships with any legislators? Please list the names and separate with a comma.
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