Tequin Lawsuit

 

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Do you have a Tequin lawsuit? Do you need to retain a Tequin lawyer?


PERSONAL INFORMATION
First Name:
Last Name:
E-mail Address:
Address:
City:
State:
Zipcode:
Phone: () - ext.
Best time to call:

CASE INFORMATION
Dates you took Tequin:
Start Date:
End Date:
Please check off all side effects that the injured party experienced:
Diabetes
Diabetic Ketoacidosis
Hyperglycemia (high blood sugar)
Hypoglycemia (low blood sugar)
Stroke
Heart Attack
Death
Suicide
Other
Additional Comments :
Philadelphia Lawyers - Pennsylvania Lawsuits at Monheit Law

Law Offices of Michael Monheit 1368 Barrowdale Road  Rydal, PA  19046
Call Us Toll Free: 866-761-1385  P: 215-840-6573  E: Michael@Monheit.com