Advocate Feedback

Below is the Advocate Feedback Form for you to fill out after meeting with your representative. This form is very important for JDRF as we move forward with our relationship with the representatives in Ottawa.

Advocate Feedback Form

*Name of official


*Level of Government:  Federal

*With whom did you speak to?

 Elected official
Assistant's Name:


*Your Name:

*Your E-mail:

*Name of Individuals who attended the meeting:

Does the Member/Assistant have any personal connection to diabetes?



Is there any other information we should know?

Is there any follow-up necessary?



If yes, by whom?

Additional Comments:


* Required Fields

You can view our Privacy Policy to see how we use the information we collect.

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