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Constituent Services Survey
Constituent Services Survey
Helping constituents is my top priority in Congress. My staff and I are here to help you navigate issues you are having with federal government agencies.
To that end, I’d like to hear from you! What constituent service(s) would you like to learn more about this year?
1. Which of the following constituent services would you like to learn more about? (please select 3)
*
a. Veterans and Military Personnel Benefits
b. Immigration & Passport Services
c. Disability Benefits Assistance
d. Retirement Services and Assistance
e. Health and Medical Benefits Assistance
f. Homeowners Resources and Assistance
g. Child Care Resources
h. Small Business Assistance
i. Disaster Assistance
j. Federal Grant Funding Assistance for Local Governments or Nonprofit Organizations
k. Postal Service Assistance
l. Employment Assistance
m. Taxes and IRS Resources and Assistance
n. Other
1. Which of the following constituent services would you like to learn more about? (please select 3)
*
is a required field.
2. Is there a specific question you have regarding any of the above listed services and benefits?
3. Have you ever received assistance from my office on any constituent service?
*
Yes
No
4. If yes, please select which service
a. Help with a federal agency
b. Grant assistance
c. Flag request
d. Tour request
e. Military Academy nomination
f. Congressional commendation
g. Other
5. If you selected 'other,' with which service did my office assist you?
6. Zooming out, what issues do you think is most important for Congress to address in 2024? (please select 3)
*
a. Addressing the disease of addiction
b. Getting big money out of politics
c. Investing in clean energy and the environment
d. Tackling the climate crisis
e. Expanding access to childcare and promoting early childhood education
f. Providing aid and assistance to regions of conflict abroad
g. Reducing the federal debt and deficit
h. Protecting our elections and securing Americans’ fundamental right to vote
i. Promoting equity and advancing civil rights
j. Combatting inflation and lowering costs for individuals and families
k. Reducing gun violence through commonsense legislation
l. Fixing our broken immigration system
m. Updating our nation’s critical infrastructure
n. Supporting the middle class and union workers
o. Protecting women's health care choices
p. Other
6. Zooming out, what issues do you think is most important for Congress to address in 2024? (please select 3)
*
is a required field.
7. If a priority of yours is not listed above, please enter it here:
8. Do you identify as any of the following?
*
a. Veteran/Active service member
b. Volunteer
c. Parent
d. Law Enforcement/First Responder
e. Business Owner
f. Farmer/Agricultural Worker
g. Government Employee
h. Student
i. None of the above
8. Do you identify as any of the following?
*
is a required field.
9. How old are you?
*
a. 18-24 years old
b. 25-34 years old
c. 35-44 years old
d. 45-54 years old
e. 55-64 years old
f. 65-74 years old
g. 75+ years old
9. How old are you?
*
is a required field.
10. In what county do you live?
*
a. Albany County
b. Saratoga County
c. Schenectady County
d. Rensselaer County
10. In what county do you live?
*
is a required field.
11. Is there any question or statement that you would like to share with my office and me?
Email Address
*
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