Office of Communications


West Virginia Department of Health and Human Resources

2013 LEGISLATIVE CONTACT FORM

(Please type in your information and use the Tab key to go to the next space.)

DHHR Staff Person:

Bureau & Office/Facility:

Legislator:

Date of Contact:

Date of Report:

Contact Received By:

Contact Topics:

Briefly summarize the contact. (What was said and who said it?  Include any other relevant information.)

Follow-up needed?

What?

Submit completed forms online within one business day to the Office of Communications and Legislative Affairs.  Ensure your legislative coordinator also gets a copy.  Make preliminary telephone reports of "hot" issues by telephone and follow-up with a written report.  Copies of any written information to be shared with legislators must be approved by the DHHR Secretary.  Submit a copy with this report, by e-mail to Sherri.E.Elsheikh@wv.gov or send to:

Office of Communications and Legislative Affairs
One Davis Square, Suite 100, East
Charleston, WV 25301
Phone: (304)558-7899
Fax: (304)558-7075

    

Office of Communications Home

Revised: 07/16/13