My Local Representatives

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Thank you for helping the 50-State Network spread the word about our Coronavirus Patient Program! Please fill out the form below for each elected official that you know of, starting with your own elected officials. You will need to click on this link each time to get a fresh form for each elected official.

You can find a list of elected officials by address here: http://myreps.datamade.us/

Please do not fill out this form for Governor, Attorney General, State (or City) Comptroller or U.S. President.

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Elected Official (Name)
Office
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