Free case review

What was it?

The product, drug, device or exposure you think caused harm.

What kind of case is this?

Dangerous drugsPrescription and over-the-counter medicines that caused harm the label did not warn about. Defective medical devicesImplants and devices that failed, broke apart, or had to come out early. Toxic exposureIllness linked to chemicals at work, at home, or in the water. Defective productsHousehold and consumer products that hurt someone during normal use. Vehicle defectsCrashes caused, or made worse, by a defect in the vehicle itself. Not sureWe will work it out together.

What was it called? The name of the drug, device or product, or the place where you were exposed. Your best guess is fine.

Who is this about?

Me A family member I am helping A family member who has died

When did you use it, or when were you exposed?

Approximate is fine. Records can fill in exact dates later.

Year it started

State at the time

How long did it go on?

Is it still going on?

Yes No, it stopped Not sure

How can we reach you?

We call within one business day. We never share your details with other firms.

Full name

Phone

Best time to call (optional)

Morning Afternoon Early evening

Records consent If your case moves forward, we will need medical, pharmacy or work records. You will see the form before you sign anything.

Yes, if my case moves forward I am willing to sign a form so the firm can request my records. I would like to talk first before any records are requested.

I understand that sending this form does not make me a client, and that Sundquist Amadi may contact me about my review.

Check your answers

Use Edit to change anything. Nothing is sent until you press the button below, and on this demo site nothing is sent at all.