Bextra Lawsuits - Bextra Lawyer information at Monheit.com

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Bextra Case Inquiry Form

Bextra lawsuits for heart attack, stroke, and other injuries handled by lawyers at Monheit Law

Bextra

Do I have a Bextra case?

Do I have a Bextra Case?

If you believe that you or a loved one has been adversely affected by Bextra, please fill out the form below. There is no charge for this Bextra case evaluation.

PERSONAL INFORMATION

First Name:

Last Name:

E-mail Address:

Phone:

() - ext.

Address:

City:

State:

Zipcode:

Date of Birth:

BEXTRA CASE INFORMATION

During what period of time was Bextra prescribed?

Start:

End

Why was Bextra prescribed?

List names/addresses of any doctors who prescribed Bextra:

Did effects from Bextra include:

Skin Rash

Yes
No

Swelling

Yes
No

Breathing Problems

Yes
No

Skin Blistering

Yes
No

Other medical problems since Bextra usage:

Have you been diagnosed with: (check all that apply)

Stevens Johnson Syndrome
Anaphylaxis
Angioedema
Epidermal Necrolysis

Erythema Multiforme
Exfoliative Dermatitis

Have you experienced the following: (check all that apply)

Sudden or unexplained death
Heart attack (Myocardial Infraction)
Unstable angina
Cardiac thrombus

Resuscitated cardiac arrest
Ulcers with permanent damage
Ischemic stroke
Transient Ischemic Attack (TIA)

Have you taken any of the following?

Bextra
Celebrex

Vioxx

Other medical diagnosis since Bextra usage:

Other Bextra Case Information:

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