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Uterine Fibroid Commission - Request for Nominees

Full Name of Nominee First and Last Name

E-Mail Address

Phone

State Senate District of Residence

• Does the nominee currently live with a uterine fibroids, polycystic ovarian syndrome, or endometriosis diagnosis? Yes
No

Statement of Interest

In addition to submiting this form, by midnight on July 25, 2025, please submit resume and/or Statement of Interest by email.

Surgeon General Ralph L. Abraham, M.D.