Thank you for your advocacy!
Name
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First Name
Last Name
Email
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Met With
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Please Select
MP
Senator
MLA/MPP/MNA/MHA
Mayor
Councillor/Alderman
Other
If you answered OTHER to the above, please provide details.
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Constituent's Name (Riding, Ward, etc.)
Name of all Advocates involved in Meeting
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Name of All Political Representatives and Staff in Meeting
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Meeting Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Meeting Time
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Hour Minutes
AM
PM
AM/PM Option
Your Ask
*
How did the legislator / staff respond to your aks?
*
Did the legislator or their staff indicate any connection to Inflammatory Bowel Disease?
*
Yes
No
Please note any other issues or questions that arose during your meeting
Is any follow-up required of Advocacy staff?
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Yes
No
If so, please explain exactly what information is requested and to whom the Advocacy staff should send a response.
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