Contact Breast Implant Lawyer Steve Frailich - Breast implant law firm, breast litigation firm, mdl 926, dow litigation

Breast Implant Class Action CONTACT FORM

Please fill out the contact form if you received Breast implants between 1965-June 1,1993, as you may be eligible to participate in the Dow Corning and/or MDL 926 class actions.

If you did not receive implants during this time period, you may want to contact a product liability attorney or the corporation that manufactured your implants.

If you would like to know what legal rights you are entitled to, at no cost, please fill out the following form.

 INFORMATION ABOUT YOU:

NAME:

ADDRESS: (Optional)

PHONE NUMBER: (Optional)

E-MAIL:

BREAST IMPLANT QUESTIONS:
Approximate Date of 1st Breast Implant Surgery:

 
Brand Name of 1st breast implant

 
Implant Model Number :

 
Implant Lot Number:

 
Do you have "Proof" of the brand of implant you received?

 
If so, what type of proof? (Example, copy of surgery report that lists brand, letter from doctor, etc.

 
Have one or more of your implants been removed?

 
Date Implant Removed

 
Did you receive new implants?

 
If so, what was brand of implant?

 
"Do you have proof of this implant?"

 
Have any of your implants ruptured?

 
If so, what Implant Brand Ruptured?

List other implant surgeries if applicable and the brand of implant.

Have you registered with the earlier MDL-926 Class Action?

If so, did you receive any money and how much?

Have you registered with the Dow Corning Class Action?

If so, has your Dow proof been accepted?

 
If so, did you receive any money and how much?
 
Do you have an existing attorney?:

Have you noticed any of the symptoms listed on the right, after you received your breast implants? 

Check all that apply:
Arthritis
Breast Deformity
Chills/Sweats
Depression
Fever
Hair Loss
Headaches
Joint Pain
Low Disease Resistance
Memory Loss
Muscle Weakness
Weight Gain
Weight Loss
None
Have you ever been treated for any of the above?:
Are you having any unexplained symptoms that you are concerned about?
Are you having problems with the claims board? If yes, please explain.
Any other information you would like to tell me that you feel is important?

Upon submitting this form, you certify that all of the information given is true and correct to the best of your knowledge. I/We understand that all The Law Offices of Stephen M. Frailich is agreeing to at this time is to look at our case and that by completing, filling out, and submitting this form to The Law Offices of Stephen M. Frailich, no Attorney-Client relationship is yet formed.

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FACT

In 1997, The Mayo Clinic found one in four women with implants will need surgery within five years for ruptures or other disfiguring complications. 
 

FACT

What effect does silicone have on the enzyme system, cell membranes, DNA damage, interference with repair mechanisms and the effect on energy production?
 

CONTACT INFO

Law Offices of 
Stephen M. Frailich
22287 Mulholland Highway,
PMB No. 409
Calabasas, Ca. 91302
(818) 223-9064
(818) 223-9062 (Fax) 
Visit breast implant law ; breast implant blog &
www.frailichlaw.com

Call Toll-Free
1-800-573-3236 (24 Hour Voice Mail)
E-MAIL: smflawcorp@aol.com