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Viagra, Cialis, and Levitra (blindness)

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Defendant:

Viagra, Cialis and Levitra (blindness)

*Describe Your Case:

Have you taken Viagra?

Yes No

If yes, how long have you taken Viagra?

Have you taken Cialis?

Yes No

If yes, how long have you taken Cialis?

Have you taken Levitra?

Yes No

If yes, how long have you taken Levitra?

Did you experience blurred vision?

Yes No

Did you or a loved one experience blindness?

Yes No

Have you or a loved one been diagnosed with NAION?

Yes No

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*Last name:

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