www.911healthupdate.com
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2600:9000:2359:fa00:6:22a5:d8c0:93a1
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Submitted URL: https://911healthupdate.com/
Effective URL: https://www.911healthupdate.com/
Submission: On July 04 via automatic, source certstream-suspicious — Scanned from DE
Effective URL: https://www.911healthupdate.com/
Submission: On July 04 via automatic, source certstream-suspicious — Scanned from DE
Form analysis 2 forms found in the DOM
POST /#gf_3
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_3" id="gform_3" class="has-small-fields" action="/#gf_3" data-formid="3" novalidate="">
<div class="gform-body gform_body">
<div id="gform_fields_3" class="gform_fields top_label form_sublabel_below description_below validation_below">
<div id="field_3_15" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_3_15"><label class="gfield_label gform-field-label" for="input_3_15">First Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_15" id="input_3_15" type="text" value="" class="large" placeholder="First Name" aria-required="true" aria-invalid="false"> </div>
</div>
<div id="field_3_16" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_3_16"><label class="gfield_label gform-field-label" for="input_3_16">Last Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_16" id="input_3_16" type="text" value="" class="large" placeholder="Last Name" aria-required="true" aria-invalid="false"> </div>
</div>
<div id="field_3_2" class="gfield gfield--type-email gfield--input-type-email gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_3_2">
<label class="gfield_label gform-field-label" for="input_3_2">Email</label>
<div class="ginput_container ginput_container_email">
<input name="input_2" id="input_3_2" type="email" value="" class="large" placeholder="Email" aria-invalid="false">
</div>
</div>
<div id="field_3_3" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_3_3"><label class="gfield_label gform-field-label" for="input_3_3">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_3" id="input_3_3" type="tel" value="" class="large" placeholder="Phone" aria-required="true" aria-invalid="false"></div>
</div>
<div id="field_3_17" class="gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_3_17"><label
class="gfield_label gform-field-label" for="input_3_17">Illness / Injury</label>
<div class="ginput_container ginput_container_text"><input name="input_17" id="input_3_17" type="text" value="" class="large" maxlength="3000" placeholder="Illness / Injury" aria-invalid="false"> </div>
</div>
<div id="field_3_6" class="gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_3_6"><label class="gfield_label gform-field-label" for="input_3_6">Message<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_6" id="input_3_6" class="textarea small" maxlength="3000" placeholder="Message" aria-required="true" aria-invalid="false" rows="10" cols="50"></textarea></div>
</div>
<div id="field_3_8" class="gfield gfield--type-captcha gfield--input-type-captcha field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible" data-js-reload="field_3_8">
<label class="gfield_label gform-field-label" for="input_3_8">CAPTCHA</label>
<div id="input_3_8" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6LedoyAaAAAAAKQTZiwteXmVRbPO9826FWW58_L_" data-theme="light" data-tabindex="-1" data-size="invisible" data-badge="bottomright">
<div class="grecaptcha-badge" data-style="bottomright"
style="width: 256px; height: 60px; display: block; transition: right 0.3s ease 0s; position: fixed; bottom: 14px; right: -186px; box-shadow: gray 0px 0px 5px; border-radius: 2px; overflow: hidden;">
<div class="grecaptcha-logo"><iframe title="reCAPTCHA" width="256" height="60" role="presentation" name="a-lltgmob7lmvx" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LedoyAaAAAAAKQTZiwteXmVRbPO9826FWW58_L_&co=aHR0cHM6Ly93d3cuOTExaGVhbHRodXBkYXRlLmNvbTo0NDM.&hl=en&v=rKbTvxTxwcw5VqzrtN-ICwWt&theme=light&size=invisible&badge=bottomright&cb=hp91lahwjq9i"
tabindex="-1"></iframe></div>
<div class="grecaptcha-error"></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div>
</div>
</div>
<div id="field_3_11" class="gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_3_11">
<div class="ginput_container ginput_container_text"><input name="input_11" id="input_3_11" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
<div id="field_3_12" class="gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_3_12">
<div class="ginput_container ginput_container_text"><input name="input_12" id="input_3_12" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
<div id="field_3_13" class="gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_3_13">
<div class="ginput_container ginput_container_text"><input name="input_13" id="input_3_13" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
<div id="field_3_14" class="gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_3_14">
<div class="ginput_container ginput_container_text"><input name="input_14" id="input_3_14" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
<div id="field_3_18" class="gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_3_18">
<div class="ginput_container ginput_container_text"><input name="input_18" id="input_3_18" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
<div id="field_3_19" class="gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_3_19">
<div class="ginput_container ginput_container_text"><input name="input_19" id="input_3_19" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
<div id="field_3_20" class="gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_3_20">
<div class="ginput_container ginput_container_text"><input name="input_20" id="input_3_20" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
</div>
</div>
<div class="gform_footer top_label"> <button type="submit" id="gform_submit_button_3" class="c-btn c-btn--sm width-100% gform_button button" value="Submit"
onclick="if(window["gf_submitting_3"]){return false;} if( !jQuery("#gform_3")[0].checkValidity || jQuery("#gform_3")[0].checkValidity()){window["gf_submitting_3"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_3"]){return false;} if( !jQuery("#gform_3")[0].checkValidity || jQuery("#gform_3")[0].checkValidity()){window["gf_submitting_3"]=true;} jQuery("#gform_3").trigger("submit",[true]); }">Submit</button>
<input type="hidden" name="gform_ajax" value="form_id=3&title=&description=&tabindex=0&theme=gravity-theme">
<input type="hidden" class="gform_hidden" name="is_submit_3" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="3">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_3" value="WyJbXSIsIjQ1Y2RiNTNhYjA1ZGY2Y2UyMTRlYjA1ZmQwZGEyYWQyIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_3" id="gform_target_page_number_3" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_3" id="gform_source_page_number_3" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
<p class="margin-top-sm text-xxs">This site is protected by reCAPTCHA and the Google <a href="https://policies.google.com/privacy" target="_blank">Privacy Policy</a> and
<a href="https://policies.google.com/terms" target="_blank">Terms of Service</a> apply.</p>
</form>POST /#gf_2
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_2" id="gform_2" action="/#gf_2" data-formid="2" novalidate="">
<div class="gform-body gform_body">
<div id="gform_fields_2" class="gform_fields top_label form_sublabel_below description_below validation_below">
<div id="field_2_15" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_2_15"><label class="gfield_label gform-field-label" for="input_2_15">First Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_15" id="input_2_15" type="text" value="" class="large" placeholder="First Name" aria-required="true" aria-invalid="false"> </div>
</div>
<div id="field_2_16" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_2_16"><label class="gfield_label gform-field-label" for="input_2_16">Last Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_16" id="input_2_16" type="text" value="" class="large" placeholder="Last Name" aria-required="true" aria-invalid="false"> </div>
</div>
<div id="field_2_2" class="gfield gfield--type-email gfield--input-type-email gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_2">
<label class="gfield_label gform-field-label" for="input_2_2">Email</label>
<div class="ginput_container ginput_container_email">
<input name="input_2" id="input_2_2" type="email" value="" class="large" placeholder="Email" aria-invalid="false">
</div>
</div>
<div id="field_2_3" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_2_3"><label class="gfield_label gform-field-label" for="input_2_3">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_3" id="input_2_3" type="tel" value="" class="large" placeholder="Phone" aria-required="true" aria-invalid="false"></div>
</div>
<div id="field_2_17" class="gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_17"><label
class="gfield_label gform-field-label" for="input_2_17">Illness/Injury</label>
<div class="ginput_container ginput_container_text"><input name="input_17" id="input_2_17" type="text" value="" class="large" maxlength="3000" placeholder="Illness/Injury" aria-invalid="false"> </div>
</div>
<div id="field_2_6" class="gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_2_6"><label class="gfield_label gform-field-label" for="input_2_6">Message<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_6" id="input_2_6" class="textarea medium" maxlength="3000" placeholder="Message" aria-required="true" aria-invalid="false" rows="10" cols="50"></textarea></div>
</div>
<div id="field_2_8" class="gfield gfield--type-captcha gfield--input-type-captcha field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible" data-js-reload="field_2_8">
<label class="gfield_label gform-field-label" for="input_2_8">CAPTCHA</label>
<div id="input_2_8" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6LedoyAaAAAAAKQTZiwteXmVRbPO9826FWW58_L_" data-theme="light" data-tabindex="-1" data-size="invisible" data-badge="bottomright">
<div class="grecaptcha-badge" data-style="none" style="width: 256px; height: 60px; position: fixed; visibility: hidden;">
<div class="grecaptcha-logo"><iframe title="reCAPTCHA" width="256" height="60" role="presentation" name="a-46gvoms4ylwj" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LedoyAaAAAAAKQTZiwteXmVRbPO9826FWW58_L_&co=aHR0cHM6Ly93d3cuOTExaGVhbHRodXBkYXRlLmNvbTo0NDM.&hl=en&v=rKbTvxTxwcw5VqzrtN-ICwWt&theme=light&size=invisible&badge=bottomright&cb=oc00oxed3fa5"
tabindex="-1"></iframe></div>
<div class="grecaptcha-error"></div><textarea id="g-recaptcha-response-1" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
</div>
<div id="field_2_11" class="gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_11">
<div class="ginput_container ginput_container_text"><input name="input_11" id="input_2_11" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
<div id="field_2_12" class="gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_12">
<div class="ginput_container ginput_container_text"><input name="input_12" id="input_2_12" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
<div id="field_2_13" class="gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_13">
<div class="ginput_container ginput_container_text"><input name="input_13" id="input_2_13" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
<div id="field_2_14" class="gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_14">
<div class="ginput_container ginput_container_text"><input name="input_14" id="input_2_14" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
<div id="field_2_19" class="gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_19">
<div class="ginput_container ginput_container_text"><input name="input_19" id="input_2_19" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
<div id="field_2_18" class="gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_18">
<div class="ginput_container ginput_container_text"><input name="input_18" id="input_2_18" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
<div id="field_2_20" class="gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_2_20">
<div class="ginput_container ginput_container_text"><input name="input_20" id="input_2_20" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
</div>
</div>
</div>
<div class="gform_footer top_label"> <button type="submit" id="gform_submit_button_2" class="c-btn " gform_button="" button'="" value="Submit"
onclick="if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_2").trigger("submit",[true]); }">Submit</button>
<input type="hidden" name="gform_ajax" value="form_id=2&title=&description=&tabindex=0&theme=gravity-theme">
<input type="hidden" class="gform_hidden" name="is_submit_2" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="2">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_2" value="WyJbXSIsIjQ1Y2RiNTNhYjA1ZGY2Y2UyMTRlYjA1ZmQwZGEyYWQyIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_2" id="gform_target_page_number_2" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_2" id="gform_source_page_number_2" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
<p class="margin-top-sm text-xxs">This site is protected by reCAPTCHA and the Google <a href="https://policies.google.com/privacy" target="_blank">Privacy Policy</a> and
<a href="https://policies.google.com/terms" target="_blank">Terms of Service</a> apply.</p>
</form>Text Content
Skip to content BARASCH & MCGARRY * Update Your Status Email Address Search the Site Menu * Update Your Status Email Address Search the Site Menu Get Directions Update Your Status 9/11 CERTIFICATION STATUS AND HEALTH UPDATE SUBMIT THIS FORM TO UPDATE YOUR RECORDS. You previously contacted Barasch & McGarry, Lawyers for the 9/11 Community, to inquire about the World Trade Center Health Program and the Victim Compensation Fund (VCF). ARE YOU ELIGIBLE? Submit this form for a free consultation "*" indicates required fields First Name* Last Name* Email Phone* Illness / Injury Message* CAPTCHA Submit This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. HAVE YOU HAD CHANGES TO YOUR 9/11 CERTIFICATION STATUS OR HEALTH? You may be eligible for free health care and compensation. YOUR 9/11 CERTIFICATION: Have you been certified by the World Trade Center Health Program for a 9/11-related illness? YOUR HEALTH: Have you experienced changes in your health that may be related to your 9/11 exposure? -------------------------------------------------------------------------------- ARE YOU ELIGIBLE? Submit this form to update your records. "*" indicates required fields First Name* Last Name* Email Phone* Illness/Injury Message* CAPTCHA Submit This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. * 11 Park Place, 18th Floor New York, NY 10007 Get Directions * Update Your Status Get Directions Update Your Status * Facebook * Twitter * Instagram * Linkedin * Youtube Prior results do not guarantee a similar outcome. Barasch & McGarry is located in New York City and serves clients in and around all five boroughs, as well as Long Island, Westchester, Putnam, Rockland, & Duchess Counties. Attorney Advertising. This website is designed for general information only. The information presented at this site should not be construed to be formal legal advice nor the formation of a lawyer/client relationship. © 2024 Barasch & McGarry. All rights reserved. * Facebook * Twitter * Instagram * Linkedin * Youtube Notifications