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MAZON Lobby Visit Report Form
Use this form to track the details of your visit with your Member of Congress
Email address *
Your Name *
Your answer
Date *
MM
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DD
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YYYY
Meeting Location *
Your answer
Legislator *
Your answer
State/District *
Your answer
People at meeting and titles (include legislative staff, MAZON staff, and partners) *
Your answer
Issues raised (check all that apply and note any specific points discussed) *
Required
What was the general response/attitude from the legislator and/or staffer(s)? Knowledgeable? Responsive?
Your answer
Key takeaways from visit - How did the legislator and/or staffer(s) respond to you? Did you glean any insight into issues his/her priorities? Concerns? Opportunities? Potential barriers? How can MAZON best cultivate the relationship?
Your answer
Was there any follow-up requested by the legislator and/or staffer(s)?
Your answer
What is your recommended follow up (not necessarily requested by the legislator and/or staffer(s))?
Your answer
Other comments / helpful facts / relationships / info about the legislator or staff
Your answer
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