PUBLIC HEARING REPLY FORM

Persons invited to present testimony at the public hearing on "Improving patient safety in New York: Understanding and improving the current system" are requested to complete this reply form Wednesday, October 14 and mail, email or fax it to:

Alison Jacobs
New York State Senate
433 Capitol, Albany, NY 12247
(t) 518-455-2630, (f) 518-426-6703

or

Richard Conti
New York State Assembly Committee on Health
822 LOB, Albany, NY 12248
(t) 518-455-4941, (f) 518-455-5939

or

Estibaliz Alonso
New York State Assembly
Alfred E. Smith Bldg, Fl. 23, Albany, NY 12248
(t) 518-455-4311, (f) 518-455-7095
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I plan to attend the following public hearing on improving patient safety in New York: Understanding and improving the current system to be conducted by the Senate Committee on Health and the Assembly Committee on Health on October 19th.
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I plan to make a public statement at the hearing. My statement will be limited to 10 minutes, and I will answer any questions which may arise. I will provide 10 copies of my prepared statement.
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I will address my remarks to the following subjects:


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I do not plan to attend the above hearing.
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I would like to be added to the Committees' mailing list for notices and reports.
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I would like to be removed from the Committees' mailing list.
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I will require assistance and/or handicapped accessibility information. Please specify the type of assistance required:


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