Celebrex Lawsuits

Please use our inquiry form if you have questions about your legal rights regarding an injury related to Celebrex. Our attorneys our available nationwide- many people have experienced heart attack, stroke and other dangerous side effects.

The information on this form will be kept private and used for the sole purpose of informing you of your rights.

We urge visitors to discuss their health care with their doctors. This inquiry form is intended only to provide legal information against the manufacturer of Celebrex. Please read and agree to our Legal Notices and Disclaimer.

Title:

First Name:

  M. I.

  

 Last Name:

 Address:

 City:

 State:

 Zip Code:

 Phone Number (day):

 Phone Number (eve):

Email Address 

 If this inquiry is not for yourself, please tell us the name of the person?:

 Title:

  

First Name:

   MI

  

Last Name:

What is the Injured's relationship to you?:

Injured's Date of Birth?
ie (mm/dd/19yy)

 Have you or they taken Celebrex?:

  Yes No

Date(s) of use?

 Do you have proof of taking these medications from:

Prescription Bottle:
 		  Yes No
Pharmacy Records:  Yes No
 Record from Doctor:  Yes No

Have you or they suffered a heart attack?

Stroke?:

  Yes No

Blood Clotting?:

 Yes No

Pulmonary Embolism? 

  Yes No

Kidney Damage? 

  Yes No

 Date of Diagnosis?:

Please briefly describe your legal concern
 
 I understand that submitting this form does not create an attorney client relationship: Agree


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