AFFF - Lawsuit
First Name
First Name
Last Name
Last Name
Email
Email
Phone
Phone
Were you or a loved one exposed to firefighting foam on the job?
Yes
No
Unsure
Were you exposed while working as a firefighter?
Yes
No
Unsure
Were you exposed to the foam in the U.S. or at a U.S.˛ military airfield or flight deck?
Yes
No
Unsure
Diagnosis or impairment since you or loved one was exposed to AFFF?
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Upload gov.id proof
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