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Select Your Concern?Paraquat LawsuitTalcum Powder LawsuitRoundup LawsuitPhilips CPAP LawsuitNEC LawsuitZantac LawsuitElmiron LawsuitHernia MeshMesothelioma LawsuitMedical MalpracticeAFFF ClaimAuto InjuryTruck AccidentDog Bite InjurySlip and Fall InjuryBicycle AccidentMotorcycle accidentTrain accidentBus AccidentWorkers CompensationBurn InjuryAmusement Park AccidentBoating AccidentsDivorce lawsuitChild Custody LawsuitStorm Damage

--Have you been diagnosed with Parkinson’s Disease?--YesNo

--Do you currently have legal representation for your Paraquat claim?--YesNo

-- Which type of cancer do you have?--Ovarian CancerInvasive Fallopian Tube Cancer

--You must have used baby powder daily within four (4) years of minimum use--YesNo

--Did you or a loved one use one of the following machines?--• DreamStation (ASV, ST, AVAPS, CPAP, Auto CPAP, BiPAP)DreamStation GO (CPAP, APAP)SystemOne (ASV4)C Series (ASV, S/T, AVAPS)OmniLab Advanced PlusDorma 400,500 (CPAP)REMStar SE Auto (CPAP)Trilogy100 and 200A-Series BiPAP V30 (Auto)Garbin Plus, Aeris, LifeVentA-Series BiPAP A40 and A30A-Series BiPAP Hybrid (A30) – not marketed in the United StatesE30 (Emergency Use Authorization)

--Did you or a loved one experience one of the following side effects?--Acute kidney injury (AKI)Acute liver injuryBrain cancerBladder cancerBreast cancer in patients under 40Chronic asthmaChronic bronchitisColon cancerEsophageal cancerHematopoietic cancer (immune cell)Hypopharyngeal cancerInterstitial lung disease (ILD)Kidney cancerLaryngeal cancerLymphatic cancer (including non-Hodgkin’s)LeukemiaLiver cancerLiver disease (acute liver injury only)Lung cancerMultiple myelomaMyeloid leukemiaNasal cancerNasopharyngeal cancerPapillary carcinomaParanasal sinus cancerProstate cancer in patients under 50Pulmonary fibrosisRectal cancerRecurrent pneumonia (4 or more times in one year)SarcoidosisScarring of lungsSevere or chronic asthmaSinus cancerSoft palate cancerStomach cancerTesticular cancerThroat cancerThyroid cancerTonsil cancer

A child who consumed one or more of the following baby food brands?--A child who consumed one or more of the following baby food brands?--Beech-NutEarth’s Best OrganicGerberHappyBABYParent's Choice (Walmart)Plum OrganicsSprout FoodsOthers

Diagnosed with a Neurological disorder or congnitive deficiency?--Diagnosed with a Neurological disorder or congnitive deficiency?--YesNo

How old was the child diagnosed?</p_

Are you/anyone in the immediate family is suffering/suffered from the following list of B-Cell/T-Cell Lymphomas.Are you/anyone in the immediate family is suffering/suffered from the following list of B-Cell/T-Cell Lymphomas.Bladder CancerEsophageal CancerLiver CancerColorectal/Intestinal CancerGastric (stomach) CancerPancreatic CancerProstate Cancer (diagnosed before 65 years old)Pediatric Cancer

Reason why it was prescriped?Reason why it was prescriped?Dyspepsia (acid indigestion)Erosive esophagitisGastroesophageal reflux disease (GERD)HeartburnHyperaciditySour stomachStomach ulcersUlcers of the intestineUpset stomachZollinger-Ellison syndrome

Have you ever used Elmiron?--Have you ever used Elmiron?--YesNo

Have you diagnosed with any of the following?--Have you diagnosed with any of the following?--Macular DegenerationRetinal DiseaseRetinal MaculopathyOther Vision Issues

Have you sign paper work with any Law Firm?--Have you sign paper work with any Law Firm?--YesNo

--Type of Medical Malpractice--Surgical ErrorsDiagnostic Errors/Failure to DiagnoseEmergency Room ErrorsHospital InjuriesBirth InjuriesPrenatal InjuriesNegligent IntubationAnesthesia ErrorsPrescription ErrorsDefective Medicine or EquipmentPlastic Surgery MalpracticeWrongful PregnancyMore than one of the aboveOthers

--Were you a civilian or military firefighter and exposed to firefighting foam (AFFF) after 1960?--YesNo

--Which of the following cancers were you diagnosed with?--Kidney CancerPancreatic CancerTesticular CancerProstate CancerLeukemiaLymphoma -NHLBladder CancerBreast CancerThyroid CancerLiver CancerOther

--Do you live in Louisiana?--YesNo

--Do you have property damage due to Hurricane Ida?--YesNo

--Do you have home insurance?--YesNo

--Do you currently have legal representation for this legal matter?--YesNo