Insurance and Benefits Assistance Request
Once a request has been submitted, Julie Shapiro from Three Little Birds will reach out within 72 hours to discuss your situation further and how Three Little Birds can help advocate on your behalf.
Your Name
Your EmailAddress
Your Phone Number
Best way to contact you?
Clear selection
Best hours of the day to contact you?
Insurance Provider?
Is your insurance through an employer, and if so, who is your employer?
Who is the insurance carrier-- yourself, a spouse, etc?
Please provide an overview of your current situation and needs (ie—the prognosis of your baby, type of care required, specific questions that you need answers, what type of benefits would assist your situation):
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