Request Assistance With a Federal Agency

In most cases, Federal law requires us to have a signed authorization from you before we can discuss your case with the agency involved. Please download, fill out and sign our Case Information and Privacy Release Form. You may use the form below to initiate a review of your request, but we may require that you complete the Case Information and Privacy Release Form (Spanish-language version available here) prior to taking action on your request.

Fields marked with an * are required.

Prefix or Military Rank

First Name*

Last Name*

Suffix

Street Address*

Street Address 2

City*

State*

Zip Code*

NOTE to service members who are California residents: please provide us with your permanent California address, not your temporary out-of-state address.

Phone*

Email Address*

Verify Email Address*

Which Federal agency or issue do you need assistance with?

Message Content*

Print Email Tweet Share Reddit

BARBARA BOXER

UNITED STATES SENATOR

CALIFORNIA

Request Assistance With a Federal Agency