Public Comments Form

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If you wish to address the Board, please fill out this form completely and submit it prior to the beginning of the meeting. You will be emailed the details of how to connect. Testimony time is limited as determined by the Board Presiding Office.

Please note: This form is not set up to receive files. If you wish to submit documentation to the board, please email it to the appropriate department according to the TSBDE Agency Contacts List.

Email *

I would like to make a verbal comment during the meeting. *

Yes

No, but I would like to submit a written comment to the Board. If so, please use the space provided below.

I am commenting on behalf of: *

I am authorized to speak for the following organization:

Speaking only as a member of the following organization:

Speaking as a private citizen.

Other:

Full Name: *

Address: *

Phone Number: *

Describe the subject of your remarks. Please be specific. *

Your comment relates to which meeting(s)?: *

Board Meeting

Anesthesia Committee Meeting

Continuing Education Review Committee

Dental Practice Committee Meeting

Disciplinary Review Committee Meeting

Licensing Committee Meeting

Stakeholder Meeting

Required

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