Protecting Immigrant Families Campaign: Documenting the Harm of DHS Public Charge Rule
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Advocate's Name *
Email Address *
Please provide a brief description of the case below. How will implementation of the rule impact your client or patient? Are they dis-enrolling from a health, nutrition or housing program? Have they or are they likely to be denied an immigration benefit?  Please do not include any identifying information in this form. If needed, a representative from the PIF campaign will follow up with you for more information. *
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