2021 Legislative Letter Form

2021 Legislative Letter

Let CSA amplify your voice and reach your Iowa representatives. You fill out the worksheet and submit a selfie if you want. CSA will use your answers to create a letter and deliver it to your representatives for you!
Full Name *

First Name Last Name
CSA Staff Name *
E-mail
example@example.com
Who are your elected representatives?

Click on the picture below to find them and then enter their names below so we know who to give your letter to.
Your House Representative is:
Your Senator is:
Introduce yourself and add a personal touch. For example; "My name is John. I have lived experience with a mental health diagnosis or disability and I just learned of the regional funding issue for my services." *
My top CSA legislative priority is: *

Legislative Priority #1 - FUNDING Legislative Priority #2 - WORKFORCE Legislative Priority #3 - MCO ACCOUNTABILITY
Explain why you chose this as your top priority in 1 or 2 sentences. *
In addition, what are some other issues are you passionate about?
How would your life change if you didn't have to worry about this specific concern? How would it make you feel?
Has staff made a difference in your life? Let your legislator know!
Use this space to thank your legislator for reading your letter. Do you want them to write back to you? If so, how can they reach you? *
Send a selfie!

Make sure legislators can put a face to a name to make your letter more meaningful.
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2021 Legislative Letter