A Stronger Downstate Public Hearing Registration Form
Thank you for your interest in participating in the Downstate Community Advisory Board’s public hearing. This is your opportunity to share insights, concerns, and recommendations regarding the financial health, sustainability, and future of SUNY Downstate Hospital.Complete the registration form to confirm your attendance and indicate whether you’d like to provide oral or written testimony. Your voice matters—help us shape the future of our healthcare community!
Contact Information
Title
Please Select
Dr.
Mr.
Mrs.
Ms.
Mx.
Prof.
Last Name
*
First Name
*
Organizational/Affliation (Optional)
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Zip Code
*
example@example.com
Are you attending as (Select one):
Individual
Representative of an organization
Elected official or government representative
Healthcare professional
Other (please specify)
Other
Testimony Preferences
Will you be providing a statement at the hearing? (Select one):
Yes
No
How will you provide your statement? (Select one):
Oral testimony (2 minutes or less)
Written testimony (500 words or fewer) upload here
Submit testimony
Upload a File
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All statements must focus on the financial health, sustainability, and future of SUNY Downstate Hospital. Please ensure language remains respectful and on topic.
Accessibility Needs
Do you require any special accommodations? (Select all that apply):
ADA accessibility assistance
Translation services
Sign language interpretation
Visual or hearing aid support
Other
Specify language
Additional Information
Are you attending as part of a group or community organization? (Select one):
Yes
No
Please specify group name:
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