**If you cannot fill in this form accurately,
you will be removed from our list**

All fields on this form with an asterisk (*) must be completed. 
Find your LOCAL legislators here: 

Hint: Local legislators are NOT: Chris Murphy, Joe Courtney, etc.

Please note, HCCT needs active members. We carefully screen our members and the more information you can supply via this form, the quicker you will be admitted to our group.  Your request to join the HCCT group will be removed, if you have not filled in this form in its entirety. Thanks for your understanding and for your interest in HCCT. Please email us at info@healthchoicect.org if you do not want to receive text messages or with any questions you might have regarding our organization.

If you'd like to make a donation, to protect medical freedoms in CT, you may do so here:  https://www.paypal.me/heathchoicect
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