If you have questions or information you would like to share with our team, please fill out this initial contact form. After you complete this form a team member will contact you as soon as possible. Name * First Name Last Name Email * Mailing Address * Phone * (###) ### #### Message * Thank you for completing this initial form. A team member will be in contact with you to further investigate the mercury exposure you may have endured. Contact Us: Intake@DelawareMercury.com (302) 551-6555