Testing OTP – Silicosis Suit

Have you ever worked in artificial stone (quartz) countertop fabrication?*

Yes

No

Have you ever been diagnosed with any of the following? Please select all that apply.*

Silicosis

Lung Cancer

Other Cancer

Rheumatoid Arthritis

Sarcoidosis

Other

No Diagnoses

Other: please describe

What State did you do fabrication in?*

Based on your answers you likely QUALIFY for a potential legal action. Please enter your contact information so that we can start the process. All information is confidential and will not be shared with unauthorized individuals.

Free consultation: After you complete this form, we will contact you for a no-cost consultation. During this conversation we will take the time to review your work history, diagnosis, and provide clear answers to any questions you may have about the legal process.

Name*

First Last

Email*

Phone*

Consent Checkboxes*

By checking this box, you confirm that you are 13 years or older. You agree to have a lawyer or call center representatives contact you. You consent to receive emails, phone calls, and text communication (including those sent using an automated system) regarding your claim, and you understand that this authorization overrides any previous registrations on a federal or state Do Not Call registry. Message and data rates may apply, and you can opt out at any time by replying STOP. *

I agree to the Terms & Privacy Policy below and understand that if I provided invalid or unmonitored contact information, my request to participate in this litigation may be revoked. I further affirm that this is my first and only time submitting this information for inclusion in this litigation, and that I will not resubmit this information at a later date. *

OTP Verify Code

Please enter your contact information so that we can finish the process. All information is confidential and will not be shared with unauthorized individuals.