Health Care Advocate Online Help Request

Current About You
Contact Information

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Fill out this form to ask for help from the Vermont Office of the Health Care Advocate. Our services are free. 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 — Include apartment number if you have one

Town

State

Zip Code

Your Problem or Question

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.)

Language

Do you need an interpreter?

Yes

Call-back language