HRT Case Review

If you believe that you or a loved one has been adversely affected by Hormone (Replacement) Therapy, please fill out the form below. Provide as much information as possible to speed the processing of your inquiry. There is no charge for this evaluation.

* - Items are required.

     Contact Information
* Title: * First Name: MI: * Last Name:

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     Case Information

What form of Hormone (Replacement) Therapy were you prescribed?
Where you diagnosed with any of the following after taking Hormone (Replacement) Therapy?
   >Breast Cancer       Yes No
   >Lobular Cancer       Yes No
   >Ductal Cancer       Yes No
   >Ovarian Cancer       Yes No
   >Gallbladder Cancer       Yes No
   >Heart Attack       Yes No
   >Stroke       Yes No

   >Blood Clots

      Yes No
If you were diagnosed with another ailment that you feel was related to taking Hormone (Replacement) Therapy please identify it/them here:
What, if any, treatment have you had?

     Disclaimers

- YES, I agree that this matter may be referred to an attorney in my area who may contact me.

- YES, I agree that by submitting this question, I will not be charged for the initial response. I understand that I am forming only a semi-confidential relationship.

- YES, I agree that the above does not constitute a request for legal advice and that I am not forming an attorney client relationship by submitting this question. I understand that I may only retain an attorney by entering into a fee agreement, and that I am not hereby entering into a fee agreement. I agree that the information that I will receive in response to the above question is general information and I will not be charged for the response to this e-mail question. I further understand that the law for each state may vary, and therefore, I will not rely upon this information as legal advice. Since this matter may require advice regarding my home state, I agree that local counsel may be contacted for referral of this matter.

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Please note that you are not considered a client until you have signed a retainer agreement and we have accepted your case.

An attorney client relationship is not established by submitting this initial contact information to our office.

If you or a loved one took Prempro, Premarin or another hormone replacement therapy and have breast cancer, blood clots, stroke, heart disease or other complications, click here to have an attorney evaluate your case for free, with no obligation. Or, call toll free, 877.786.1LAW (1529). Any information you submit is kept private and confidential and is used for the sole purpose of evaluating your potential case.

Prempro Class Action Lawyer Website Disclaimer: The prempro class action lawsuit, premarin side effects, provera injury, mass tort drug litigation and/or other legal information offered herein by VanDerGinst Law is not formal legal advice nor the formation of an attorney client relationship. Our law firm handles law suits . Any results set forth here were dependent on the facts of that case and the results will differ from case to case. Please contact a premarin lawsuit attorney for advice on your rights.

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