CPAP - Lawsuit
First Name
First Name
Last Name
Last Name
Email
Email
Phone
Phone
Did you use a Philips brand machine?
Yes
No
Unsure
Did you seek medical treatment for your injury?
Yes
No
Unsure
Have you suffered any of the following injuries as a result of using a CPAP, BiPAP or ventilator machine?
Head, neck, liver, lung, or kidney cancer
Damage to the kidneys, liver, or lungs
Other injury
Unsure
Not injured
Upload gov.id proof (.png, .jpg, .pdf)
Upload gov.id proof
Comments
Comments
By clicking the "SUBMIT" button below, I affirm that I am 13 years of age or older and provide my express written consent to receive autodialed and/or prerecorded telemarketing calls and text messages from
Lawsuit Support
at the telephone number I provided above, including my wireless number, if applicable. I understand that my consent is not a condition of service and that I may revoke my consent at any time by following the opt-out instructions provided in the communications. I have also read and agree to the
Privacy Policy
Submit
Back