Texas Optometry Board

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Virtual Public Comment Form

If you are participating virtually, you may make a public comment at the appropriate time noted on the Committee/Board Agendas. The time allowed to an individual may be limited at the discretion of the Committee/Board Chair. Be advised that the Committee/Board members may not be able to answer questions or address you concerns.

Please fill out this form prior to making a public comment.

Your Name *

Organization *

Address *

Email *

Phone Number *

List Committee Name / Board Meeting Providing Comment

Agenda Item you are commenting on *

Electronic Signature (by typing your signature below, you are de facto submitting an electronic signature) *

Date *

YYYY

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Texas Optometry Board. Report Abuse

Forms