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Summer Legislative SNF Visits
This form will be used to record when your Legislative Visits are scheduled. We will send out another form for feedback after the visits have occured.
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Facility
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Name of person completing form:
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Who is your NYS Assemblyperson?
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Date of Assemblyperson visit to your SNF
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DD
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YYYY
Who is your NYS Senator?
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Date of NYS Senator Visit to your SNF
MM
/
DD
/
YYYY
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