2021 Legislator Feedback Response

Legislator Visit Feedback Survey

Please give us any feedback that you received from your visit with either the legislator or their staff on issues that you discussed.

Question Title

* 1. Appointment Date/Time

Date / Time

Date

Time

AM/PM

Question Title

* 2. Was this a Senate or House member visit?

Senate

House

Question Title

* 3. Did you talk to the member or their legislative assistant

The member

The legislative assistant

Both

Question Title

* 4. Who was with you when you visited this office?

Question Title

* 5. Which bills or issues did you talk about?

Question Title

* 6. Please share any comments from the legislator or the legislative assistant. Include whether they were for or against an issue

Question Title

* 7. Please provide us your contact information

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Cell Phone Number