PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on Electroconvulsive Therapy (ECT) are requested to complete this reply form as soon as possible and mail it to:

Carl Letson
Legislative Associate
Assembly Committee on Mental Health, Mental Retardation and Developmental Disabilities
Room 522 - Capitol
Albany, New York 12248
(518) 455-4371
(518) 455-4693 (fax)

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+-+ I plan to attend the following public hearing on Electroconvulsive Therapy (ECT) to be conducted by the Assembly Committee on Mental Health, Mental Retardation and Developmental Disabilities on July 18, 2001.

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+-+ I plan to make a public statement at the hearing. My statement will be limited to 10 minutes, and I will answer any questions which may arise. I will provide 10 copies of my prepared statement.

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+-+ I will address my remarks to the following subjects:

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+-+ I do not plan to attend the above hearing.

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+-+ I would like to be added to the Committee mailing list for notices and reports.

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+-+ I would like to be removed from the Committee mailing list.

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+-+ I will require assistance and/or handicapped accessibility information. Please specify the type of assistance required:

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NAME: ______________________________________________________

TITLE: ____________________________________________________

ORGANIZATION: ______________________________________________

ADDRESS: ___________________________________________________

TELEPHONE: _________________________________________________

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Save these dates!
September 11 - 14, 2001
NYAPRS 19th Annual Conference
'Integration, Innovation and Inspiration:' Expanding the Circle of Support at the Nevele Grande Resort, Ellenville New York
contact: Mary McLaughlin, NYAPRS
1 Columbia Place Albany, NY 12207
(518) 436-0008; fax: (518) 436-0044

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