Home
Investigations
Lawsuits
Settlements
Legal News
FAQ
Blog
Home
> Request Legal Help
Request Legal Help
AMO Lens Solution Canada (may cause blindness)
Please complete this claim form to request a free case evaluation from a lawyer listed on BigClassAction.com.
Fields marked
*
are required.
Defendant:
(who caused the harm?)
AMO Lens Solution Canada (may cause blindness)
*
Describe your complaint:
(briefly describe the damages you have suffered)
Name of product used:
Do you still have the product or proof of purchase?
Yes
No
Length of time product was used:
Frequency of use (daily, weekly, etc.)
Description of infection or illness:
Description of required treatment :
Prognosis (if known)
Was surgery required?
Yes
No
If so, what surgery and when?
Name, address, telephone number of Ophthalmologist:
Name, address, telephone number of family physician:
Summary of expenses for treatment, medications, etc. (please list each item and the associated expense)
Other comments:
*
First name:
*
Last name:
*
Email address:
*
Confirm email address:
*
Phone number(s):
*
Zip/Postal Code:
Best time & way to contact you:
I would like to be interviewed by a journalist.
Receive our weekly newsletter by our sister publication LawyersandSettlements with the latest lawsuit news and legal information.
View last issue
By submitting this form I agree to the
Terms of Service
.
There is absolutely no cost to you to submit this form. Doing so places you under no obligations and does not establish an attorney-client relationship.