West Virginia Department of Health and Human Resources
2003 MEDIA CONTACT FORM
(Please type in your information and use the Tab key to go to the next space.)
DHHR Staff Person:
Bureau & Office/Facility:
Reporter/Media Outlet:
Date of Contact:
Date Report will be Published/Aired:
Contact Topics:
Briefly summarize the contact. (What was said and who said it? Include any other relevant information.)
Follow-up Needed by Communications staff? Yes No
What?
Submit completed forms online within one business day to the Office of Communications. Make preliminary telephone reports of "hot" issues by telephone and follow-up with a written report. Submit this report, by e-mail to jpayne@wvdhhr.org or send to:
Office of Communications and Legislative Affairs Capitol Complex - Building 3, Room 206 Charleston, WV 25305 Phone: (304)558-7899 Fax: (304)558-7075
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