1.Your Name

2.Your email address

Please share information about your meeting with your House of Representatives member.

3.Which House of Representatives member did you meet with? Please include staffer name as well.

4.Did the staffer or Representative have a connection to cancer? If yes, please provide details.

5.Did the staffer or Representative show interest in supporting the CCPCA? If so, please provide details.

6.Did the staffer or Representative have questions about the legislation that NCCS needs to follow up on?

7.Please share any other details that may be important:

Please share information about your meeting with your first Senate meeting.

8.Which Senator did you meet with? Please provide name of staffer as well.

9.Did the staffer or Senator have a connection to cancer? If yes, please provide details.

10.Did the staffer or Senator show interest in supporting the CCPCA? If so, please provide details.

11.Did the staffer or Senator have questions about the legislation that NCCS needs to follow up on?

12.Please share any other details that may be important:

Please share information about your meeting with your second Senate meeting.

13.Which Senator did you meet with? Please provide name of staffer as well.

14.Did the staffer or Senator have a connection to cancer? If yes, please provide details.

15.Did the staffer or Senator show interest in supporting the CCPCA? If so, please provide details.

16.Did the staffer or Senator have questions about the legislation that NCCS needs to follow up on?

17.Please share any other details that may be important: