Who is your Legislator?
As a part of trying to make a legislative footprint for our profession, we want to try to visit the offices of our local legislators to introduce ourselves and to discuss any issues of concern we might have.  Legislators often are more eager to meet with and listen to constituents in their districts.  It would help us and our profession if you would join us on a visit to your local legislator (even just your presence as a constituent makes a huge difference).  If you are interested in attending a legislative visit with us, please let us know who your legislator is by completing the googledoc link below.

To find your state legislators: http://findyourrep.legislature.ca.gov/
 
To find your US representative: https://www.house.gov/representatives/find-your-representative
Sign in to Google to save your progress. Learn more
Last Name *
First Name *
Email *
Phone number (optional, but would help if it is a better form of contact than email)
Professional Affiliation (if none, can check "other" and put "none") *
Required
CA Assembly member *
CA Senator *
US House of Representatives *
If you are an independent pharmacy owner, would you be open to inviting a legislator to visit your pharmacy? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Western University of Health Sciences. Report Abuse
Google Forms