Constituent Services Request Form

Rep. Connolly considers each and every constituent service request to be a top priority. Working together with his legislative aide, Chris Addis, Rep. Connolly can help you navigate Government agencies and services including: Unemployment Assistance*, SNAP Benefits, MassHealth** eligibility, Paid Family and Medical Leave, and more. All information shared on this form is confidential.

Please note that issues with Federal Agencies including Social Security, Veterans Affairs, and the Internal Revenue Service (IRS) are best directed to Federal Representatives.

*For Department of Unemployment assistance, please include your claimant ID

**For MassHealth/Health Connector assistance, please click here to access the "Permission to Share" form

Describe your request

First Name

Last Name

Mobile phone (optional)

Address (Street, City, State, Zip)

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