NYSSA Legislative Day 2026
Tuesday, May 12, 2026
Please note that WE NEVER ASSUME a member is attending or that address information has not changed from year to year. You must complete the following information.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
NYSSA District
*
Please Select
District 1
District 2
District 3
District 4
District 5
District 6
District 7
District 8
Unsure
Home Address (P.O. Boxes cannot be used)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Work Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is this your first year participating?
*
Yes
No
If no, how many years have you attended?
Are you attending with another Physician NYSSA Member? If yes, name of members(s):
Time must end meetings by:
Any Additional Special Requests for Legislative Visits?
Submit
Should be Empty: