If you can't get an answer from a federal agency in a timely fashion, or if you feel you have been treated unfairly, my office may be able to help resolve a problem or get you the information you need. While we cannot guarantee you a favorable outcome, we will do our best to help you receive a fair and timely response to your problem.
Residents of the 4th Congressional District of Massachusetts can contact me for assistance in dealing with Federal agencies. In order to better serve you, this form will generate a printable page that you should sign and mail to my office.
Please include all pertinent information and claim numbers in your correspondence—such as:
- Your Social Security number for a case involving Social Security;
- VA claim number for a case with Department of Veterans Affairs;
- Taxpayer identification number (Social Security number, if individual) for an Internal Revenue Service problem, etc.;
- Your address, home phone number, daytime phone number (if different from home) and email address so that we can obtain any additional information from you that might be necessary;
- Copies of any related documents or correspondence that you may have from the agency involved;
Please download the fillable PDF here.
This shall serve as authorization under Public Law 93-579 or other applicable privacy laws and guidelines including those privacy laws covered by the Health Insurance Portability and Accountability Act (HIPAA), to allow any agency or department to provide you or your staff with information that may be confidential.
The Privacy Act of 1974 (5 U.S.C. § 552a) requires that Members of Congress or their staff have written authorization before they can obtain information about an individual's case.
We must have your signature to proceed with this type of request.