2019 MHA Legislative Conference

 
Click here to go to MHA Legislative Conference website
Hyatt Regency Washington on Capitol Hill
Please click here to book your hotel room at the Hyatt Regency Washington on Capital Hill.
MHA is pleased to host the MHA Legislative Conference and to offer its services to help set up meetings with your members of Congress. Please complete this form to facilitate the registration process and congressional visits.
Please select one*
[Clear Selection]


Participant Information
First Name*
Last Name*
Title*
Degree(s)
Business Phone*
Cell Phone
Email Address*
Primary Pharmacy Location   Primary Hill visits will be set-up using this location.
Pharmacy/Company Name*
Pharmacy/Company Address*
City*
State*
ZIP (Postal Code)*
Additional Pharmacy Locations
Number of additional locations  In order of legislative priority
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