ACP’s ‘In Their Own Words’ Campaign - Submission Form

ACP needs short, personal stories from physicians about the impact of the Medicare cuts to compile and format into eye-catching testimonials for each state. ACP leaders will deliver them to members of Congress during a special “In Their Own Words” Day on Capitol Hill during the week of September 11. The goal of this campaign is to convey to Congress the real and personal impact of the Medicare cuts on their constituents---both the doctors and their patients who are Medicare beneficiaries.

Note: Fields marked with * are required.

*Name:
   
*City:
   
*State:
   
*E-mail:
   
Practice Type/Hospital Affiliation:
   

*Personal Story:

 

Please Submit this form by Thursday, September 7. Contact Tracy Novak immediately at tnovak@acponline.org or 800-338-2746 ext. 4532 with questions or problems. Thank you