Medical Debt Personal Story

Share Your Medical Debt Personal Story

 

Company (If Applicable)

Full Name*

Email (required)

Address Line 1

Address Line 2

City

State

Zip Code

Main Phone
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Tell Your Story*

 

IMPORTANT NOTICE:

The information you provide in connection with signing the petition for the Credit 911 Medical Relief Bill will NEVER BE SOLD. If you choose to share your story, and we feel it will be inspirational to others, we will request your approval in advance, and your approval must be expressly provided to us, before sharing your story in any media format

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