Hill Visit #1

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* 1. Your Name:

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* 2. Elected official's office:

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* 3. Elected official's name:

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* 4. Was the elected official present at your meeting?

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* 5. Staff Member's name and title:

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* 6. Please select the issues you discussed with your elected official (or staff) and his/her reaction to each.

  Strongly support Support Neutral Oppose Strongly oppose Did not discuss
Mental Health First Aid Act
Comprehensive Addiction and Recovery Act
Mental Health Access Improvement Act
Comprehensive Mental Health and Addiction Reform
FY 2016 Appropriations

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* 7. Did your elected official's office ask for any additional information or follow-up? If yes, please address the information or follow-up requested in the box below.

T