If you are not
currently involved in litigation related to problems with Lotronex
then we can help you. Send the required information using the
form below and we will contact you to discuss your options.
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First Name:*
Last Name:*
Street
Address:
City:
State:
Zip:
Email:*
Daytime
Phone:*
Evening Phone:
Date of Birth:
(01-01-2000)
Drug Information
Describe medical history for Gastrointestinal Disease prior
to LOTRONEX Use:
Physician Name/Address who prescribed LOTRONEX:
Date Started LOTRONEX:
(Ex. 02/01/01)
Date Ended LOTRONEX:
(Ex. 02/01/01)
Dosage of
LOTRONEX
You Were Prescribed:
List any problems you developed while you were taking
LOTRONEX:
When did you first suspect that you had adverse effects as a
result of taking LOTRONEX?
Did a doctor ever tell you that you were
injured as a result of taking
LOTRONEX: Yes
No
If so, when?:
(Ex. 10/12/01)
Have you had any other testing or treatment as a result of
taking this medication: Yes
No
If so, describe what kind of tests or
treatment and results:
Additional Information
Do you currently have an attorney who represents you on your
LOTRONEX claim? Yes
No
Personal Injury Attorney Disclaimer: This website provides general information about Pennsylvania Lotronex lawsuits and other legal information. Nothing on this site is intended to be legal advice. The materials on this site may be considered advertising. Nothing on this site constitutes the formation of an attorney client relationship. This website is not intended to solicit clients outside the Commonwealth of Pennsylvania. In order to discuss representation, we must personally speak with you and enter into a signed, written agreement for representation. By utilizing this site, you agree to the foregoing.
