AdvocacyOur Letter | Endorse Our Letter

Last update: 04/28/2011

EXPIRED

* Indicates required fields necessary to be included in the petition.

Name:

*

Address:

City, State, Zip:

*

E-mail:

Please also tell a friend by email
and thank you for your assistance!

Privacy Policy for Collected User Information:

Any information collected within this form is used only for the expressed purpose of the appeal to the CMS and our representatives regarding the policy and letter in question.

It is not required for submission of your endorsement  that you provide details that are personally identifying, such as your full name or your e-mail address. However, that information would be necessary for us to send you a response, and for your representative to have confidence in the endorsement.

We collect personally identifiable information (name and e-mail address) only if specifically and knowingly provided by you.

Collected information is stored in a secure location of the website,  and cannot be accessed by visitors.

No personal information collected is sold or otherwise transferred to a third party.