Advocacy Day 2026!
Thursday, February 12th
Name of Registrant
*
First Name
Last Name
Email
*
example@example.com
If you CANNOT attend, would you like to add your name to a prepared letter to your legislators? It will advocate for specific bills to expand access to addiction services.
*
Please Select
Yes
No
Home Address: Please list your personal home address — this helps ensure that you are connected with the representative/senator from the district where you live and are most directly impacted. If you are currently in treatment, we ask that you use your home or family address if that fits your situation. If you do not have a personal address at this time, you can use the treatment center’s address instead. Example: Before entering treatment, I was living at my family’s home — that would be the address I would use here.
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Any questions or comments?
Submit
Should be Empty: