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If you are having trouble finding a clinic in your area or you are in need of financial assistance fill the form out below and someone will contact you. Your information is private and confidential, we will never share your information with a third party without direct permission.
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Name *
Telephone *
Email *
Best way to contact you *
Do you need financial assistance to help pay for an IUD? *
What is your current age? *
What is your zip code? *
Have you visited any clinics?
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If you have, which ones and how much does an IUD cost there?
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