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IANL- Covid-19 Contact Form
Please fill out the short form below and one of the IANL volunteers will contact you.
NOTE: The information you provide will be strictly confidential and we will not share with anyone that you have contacted us.
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Full Name
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Your answer
Phone Number
*
Your answer
Mailing Address
*
Your answer
Choose one to indicate how Covid19 impacted you
*
if you choose other below, please specify
Lost job or reduced work hours
Excessive medical expenses
Added food cost and utility bills
Other:
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