Congressional State District Visit Report Form

AOTAction Network

(NOTE: Download or Print Out and complete this form, OR send this same information via e-mail) 

What you learned during your visits with your Member(s) of Congress is very important to the AOTA lobbying program. Please complete this form and mail it to Darlene Dennis, AOTA, 4720 Montgomery Lane, PO Box 31220, Bethesda, MD 20824-1220, fax 301-652-7711, or e-mail FAD@aota.org.

AOTA ID #


Name


Address



Telephone (Work)


(Home)


Met with:

Name of Legislator


Name of Legislative staff


Location & Approximate length of meeting/visit


Was Legislator present? ______Yes _______No

Issues discussed




Should AOTA Federal Affairs Dept. staff do any follow-up to this meeting?

Provide additional material? If so, please specify.




Did you feel well prepared for this meeting? If not, what should have been different?



8/19/1999



Last Updated: 5/14/2012
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