Health Care Advocate Online Help Request

1 Current: About You
2 Contact Information
3 Submit

Hidden Phone

Fill out this form to ask for help from the Vermont Office of the Health Care Advocate. If you have a time-sensitive, urgent need, please call us instead.

You must fill in the fields that are marked with *

First Name

Last Name

Address

Town

State

Zip Code

Tell us about your health care or health insurance issue in one or two sentences. (If there is someone helping you and you'd like us to contact them, please include their contact information.)