Los Angeles County Commission on HIV
PUBLIC COMMENT FORM

Public Comment is an opportunity for members of the public to comment on an agenda item, or any item of interest to the public, before or during the Commission’s consideration of the item, that is within the subject matter jurisdiction of the Commission.

To submit Public Comment, please complete this form in its entirety and submit. You may also email your Public Comment to the Commission office at hivcomm@lachiv.org. All Public Comment will be made part of the official record.

Question Title

* 1. Contact Information

Name

Organization/Agency *if applicable

Email Address

Phone Number

Question Title

* 2. Indicate agenda item or agenda number *if applicable

Question Title

* 3. Indicate Commission meeting date. If Committee meeting, indicate which Committee and meeting date.

Question Title

* 4. Public Comment:

Question Title

* 5. Supporting Materials *if applicable

Attach Word, Excel, or PDF supporting document(s). (2 attachments limit)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Los Angeles County Commission on HIV PUBLIC COMMENT FORM

Question Title

* 1. Contact Information

Question Title

* 2. Indicate agenda item or agenda number *if applicable

Question Title

* 3. Indicate Commission meeting date. If Committee meeting, indicate which Committee and meeting date.

Question Title

* 4. Public Comment:

Question Title

* 5. Supporting Materials *if applicable

Los Angeles County Commission on HIV
PUBLIC COMMENT FORM