Select one filing method only. Do not submit the same requests electronically and by mail. CICP does not accept Letters of Intent via fax or email.
A Letter of Intent to file a Request for Benefits Form may be submitted to ensure that you meet the one-year filing deadline. However, if you submit a Letter of Intent, you must still file Request for Benefits Forms as soon as possible.
To electronically submit a CICP Letter of Intent, login above. Select the option “Upload Additional Documents”, and then upload your letter of intent.
To file a CICP Letter of Intent via mail, send documentation through U.S. Postal Service mail or a private courier to the following address:
U.S. Department of Health and Human Services
Health Resources and Services Administration
Countermeasures Injury Compensation Program
5600 Fishers Lane, 08N146B
Rockville, MD 20857
The postmark or its equivalent (e.g., the delivery date provided by the commercial carrier) will be considered the filing date to determine if you met the filing deadline.
Please make sure:
- A Letter of Intent includes your full name and a statement that indicates your intent to submit a Request for Benefits. Please do not include any additional personal identifiable information (Social Security Number, medical, legal, or financial documents) in this letter.
For more information about CICP: 1-855-266-2427 (CICP) or firstname.lastname@example.org.