2024 ASA/NCCAOM Registration for a Virtual Congressional Meeting

Question Title

* 1. Provide your contact information below and a member of ASA/NCCAOM staff will contact you to fulfill your virtual meeting request.

Name

Address

City/Town

State

ZIP/Postal Code

Email Address

Question Title

* 2. Please indicate whether you would like to meet virtually, or in person in Washington, D.C.

I would prefer to meet virtually

I would prefer to meet in person in Washington, D.C.

Question Title

* 3. Please provide your affiliation to H.R. 3133, the "Acupuncture for Our Seniors Act"

Acupuncturist

Student Acupuncturist

Patient of Acupuncturist

Ally of the Acupuncture Profession (please describe below)

Question Title

* 4. Please state your preferred availability Monday-Friday between 10:00am and 4:30pm ET.