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* 1. Name (First and Last)

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* 2. Please list the congressional office(s) you met with and the date(s).

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* 3. Who did you meet with and what is their contact information?

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* 4. Will they support funding for medical research at current budget levels?

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* 5. Does ASN need to follow up with anyone to answer questions or provide further information?

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* 6. Did you get pictures from any of your meetings?

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* 7. Was the information ASN provided helpful? Conversely, is there any other information that would have been helpful for you to have?

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* 8. Overall, how was your experience?

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* 9. Is there any additional information you would like to share?

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