Government Affairs Committee: Sign up to get involved 1. Default Section Question Title * 1. Your Name: Question Title * 2. Your email address: Question Title * 3. Are you actively involved in your state medical society or a specialty society? Yes No If yes, please tell us the name of the organization(s): Question Title * 4. Do you treat or personally know someone who has influence on state policy decisions? Yes No Question Title * 5. Do you treat or personally know someone who has influence on federal policy decisions? Yes No Done