HOT LEGAL ISSUES
LEGAL NEWS
LAWSUITS
SETTLEMENTS
FAQS
STATE LAW
LAWSUITS NEWS & LEGAL INFORMATION
Permax (serious heart valve damage)
Please complete this claim form to request a free case evaluation from a lawyer listed on LawyersAndSettlements.com.
Fields marked
*
are required.
Defendant:
(who caused the harm?)
Permax (heart damage)
*
Describe the nature of your complaint in one short sentence:
Do you have a copy of your medical records?
Yes
No
Can you get a copy of your medical records?
Yes
No
Please indicate the approximate length of time that you used Permax:
Do you still have your prescription bottles?
Yes
No
How many milligrams of Permax did you ingest each day?
Describe the medical condition or conditions which you believe may have been caused by your use of Permax:
Has any doctor told you that this medical condition was caused by your use of Permax?
Yes
No
*
First name:
*
Last name:
*
Email address:
*
Confirm email address:
*
Phone number(s):
*
Zip/Postal Code:
Best time & way to contact you:
I would like to be interviewed by a journalist.
Receive our weekly newsletter with the latest lawsuit news and legal information.
View last issue
By submitting this form I agree to the
Terms of Service
.
There is absolutely no cost to you to submit this form. Doing so places you under no obligations and does not establish an attorney-client relationship.