Home
About
Our Services
Camp Lejeune Lawsuit
Philips CPAP Lawsuit
Hair Relaxer Lawsuit
AFFF Lawsuit
Roundup Lawsuit
Zantac Lawsuit
Paraquat Lawsuit
Hernia Mesh Lawsuit
B2C Services
Baby Formula Lawsuit
Auto Vehicle Accident Lawsuit
TIVAD / Port Catheter Lawsuit
Contact
+1 (512) 215-4551
Call Us For Free Consultation : 24/7
Home
About
Contact
Our Services
Camp Lejeune Lawsuit
Philips CPAP Lawsuit
Hair Relaxer Lawsuit
AFFF Lawsuit
Roundup Lawsuit
Zantac Lawsuit
Paraquat Lawsuit
Hernia Mesh Lawsuit
B2C Services
Baby Formula Lawsuit
Auto Vehicle Accident Lawsuit
TIVAD / Port Catheter Lawsuit
Contact Info
+1 (512) 215-4551
Call Us For Free Consultation : 24/7
Philips CPAP Lawsuit
Home
Philips CPAP Lawsuit
Case Review Form
First Name
*
Last Name
*
Email
*
Phone Number
Province or Territory :
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland & Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Not in Canada
How many devices do you have?
Which device do you have?
A-Series
BiPAP
C Series
Dorma
DreamStation
E30
Garbin Plus
OmniLab
REMStar
Restar
Restart
SystemOne
Trilogy
Other
If you chose Other, please identify the device(s):
How much did your device cost? If you have multiple recalled devices, use the cost of all of them together If you do not know, leave this field blank.
Who used the device(s)?
Me
My living family member
My deceased family member
Someone else
Did that person use O-zone cleaning solution?
Yes
No
Was that person prescribed the device(s)?
Yes
No
How often did that person use the device(s)?
Is that person still using the device(s)?
Yes
No
If you chose No, when did you stop?
If you chose Yes, was this based on a doctor’s recommendation?
Have you gotten a replacement device?
Yes
No
If so, how much did you spend on the replacement device?
What symptoms has the person who used the device experienced?
Cancer
Digestive problems (nausea, vomiting)
Eye problems (burning, irritation, itchiness, redness)
Mental problems (dizziness, headaches, hypersensitivity, vertigo)
Respiratory problems (asthma, chest pressure, coughing, irregular breathing, nose irritation, shortness of breath, sinus infections, throat irritation)
Skin problems (irritation, itchiness, lesions)
Other
If you chose Other, please describe the other symptom(s)
Has the person experienced mental distress or mental health issues from discovering that the device(s) are unsafe?
Yes
No
Has the person consulted a medical professional about these symptoms?
Yes
No
Other Comments
By clicking on the 'SEND' button below, I affirm that I am 13 years or older and I consent to receive autodialed and/or prerecorded telemarketing calls from or on behalf of
thesparkcore.com
at the telephone number I provided above, including my wireless number , if applicable and associated entities, and I understand that such consent is not a condition of service.
*
Send a message
