Roundup Claim - Free Case Evaluation

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Roundup Exposure

Were you or a loved one exposed to Roundup?

Yes

I was directly exposed to Roundup

I was not exposed to Roundup

Exposure Duration

Did you or your loved one use or were exposed to Roundup Weed Killer for at least 1 year?

2 or more years

1 year

Less than 1 year

Not exposed

Cancer Diagnosis

Which of the following cancers do you suffer from?

Other Cancer Type

Please specify the type of cancer you have been diagnosed with.

Year of Diagnosis

What was your year of diagnosis?

Your Age

What is your age range?

18 to 29

30 to 49

50 to 65

65+

Legal Representation

Do you already have an attorney representing you regarding your Roundup exposure?

Yes

I already have legal representation

I do not have an attorney yet

Your Law Firm

What is the name of your law firm?

Contact Information

Please provide your contact details so we can reach you.

First Name *

Last Name *

Email Address *

Please enter a valid email address.

Phone Number *

US number, 10 digits

Please enter a valid 10-digit phone number.

Briefly describe what happened *

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Note: Please ensure that you have a diagnosis for the cancer selected. If you have not been diagnosed with cancer we will not be able to help.

Note: Please ensure that you have a diagnosis for Non Hodgkins Lymphoma or another form of blood cancer on our list. If you do not have a cancer on the list we are unable to provide assistance with the Roundup Lawsuit.