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Vioxx (heart attack and stroke)
Please complete this claim form to request a free case evaluation from a lawyer listed on BigClassAction.com.
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Defendant:
Vioxx (heart attack and stroke)
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Describe Your Case:
Have you or a loved one experienced Myocardial infarction?
Yes
No
Have you or a loved one experienced Unstable angina?
Yes
No
Have you or a loved one experienced Cardiac thrombus?
Yes
No
Have you or a loved one experienced Resuscitated cardiac arrest?
Yes
No
Have you or a loved one experienced Ischemic stroke?
Yes
No
Have you or a loved one experienced Transient ischemic attacks?
Yes
No
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Date of Birth: (mm dd yy)
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Date of incident:
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How long have you used Vioxx?
Has a loved one experienced sudden or unexplained death?
Yes
No
Do you have a copy of medical records?
Yes
No
Can you get a copy of medical records?
Yes
No
Were you or a loved one taking Vioxx at the time the injury was suffered?
Yes
No
If Vioxx was not being taken at the time of the heart attack, stroke, etc.; how many days were there between the last day Vioxx was taken and the heart attack, stroke, etc.?
State dates of Vioxx use: from when (month, day, year) to when (month, day, year):
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First name:
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Last name:
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Email address:
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Confirm email address:
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Phone number(s):
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Zip/Postal Code:
Best time & way to contact you:
I would like to be interviewed by a journalist.
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