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* 1. Name

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* 2. What is your profession?

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* 3. Email address

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* 4. Name(s) of the legislator(s) that you met with:

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* 5. Where and when did you meet with your legislator(s) (i.e. office, legislative reception, townhall, other)?

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* 6. What was discussed during the meeting with your legislator(s)?

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* 7. Was/Were your legislator(s) supportive of NPs and reimbursement issues?

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* 8. If your legislator(s) was NOT supportive of our reimbursement initiatives, why not?

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* 9. Is your legislator(s) or a member of their family currently being seen by a Nurse Practitioner?

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* 10. Additional information you would like us to know:

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