NC Legislative Day Registration Part II

You have already registered for Legislative Day through the conference, but there’s one last step you need to complete!

We are in the process of forming the cross-agency lobbying teams and we need the below information to pair you with other attendees. Your home address will be used to match you with your legislators. All of your information will be kept confidential and will only be used for scheduling purposes.

Please complete this form by Friday, April 12th. Questions should be directed to Courtney Hodges at courtney@ahhcnc.org or Cai Yoke at cyoke@bayada.com. Thank you!

Question Title

* .

First Name

Last Name

Email Address

Agency

Home Address

Home City

Home State

Home Zip

Question Title

* What is your primary advocacy priority?

Private Duty Nursing (PDN) (rate increase to $45/hr)

Personal Care Services (PCS) (rate increase to $17/hr)

Home Health (protecting CON)

Hospice (protecting CON)

Other (please specify)

Question Title

* Are you willing to be a team leader?

Yes

Question Title

* Is there a specific legislator you’d like to meet with?

Yes (please specify the legislator's name)