Skip to main content

Brain Injury Contact Form

If you would like to contact a brain injury specialist, please complete the form below. If you need immediate assistance, click on the appropriate button below or call (855) 581-8111, or text (855) 895-8398.

You have taken an important step by filling out this confidential form. By checking the box below you acknowledge the YLI Privacy Policy and agree to have an Iowa Life Counselor contact you.

CAPTCHA