Law Forum: Fen-Phen Lawyers - White River Bluffs, Indiana

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FAQs
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AHP Settlement

To locate an attorney to evaluate your case, choose from a practice area below:

Fen-Phen
Free Case Evaluation
White River Bluffs, Indiana Lawyers

Please complete the form below to contact a Fen-Phen Lawyer in White River Bluffs, Indiana. Be sure to complete all fields in full and be as descriptive as possible about your case so that we can be as thorough as possible with our free case evaluation.

First Name:

Last Name:

Street Address:

Suite:

City:

State:

Zip Code:

Home Phone:

Work Phone:

Cell Phone:

Fax:

Email:

Are you currently represented by counsel in a Fen-phen claim?

Yes No

Do you have a Pending Green Form Claim with the AHP Settlement Trust?

Yes No

If so, which Level of Matrix compensation did you claim on your Green Form?

Indicate which of the following you have or have received:

A copy of my Pink or Blue Form
A copy of my Green Form
My Diet Drug Claim Number
$6,000 or $3,000 from the Settlement
Matrix Level Compensation Payment
Reimbursement for Cost of Diet Drugs
Free Screening Program Echocardiogram

Are you timely registered with the Fen-phen Settlement?

Yes No

Was your claim for Matrix Level compensation denied?

Yes No

Did you Opt-Out of the 7th Amendment?

Yes No

Has your doctor recommended surgery to repair or replace your diseased valve?

Check all of the following that apply:

I was diagnosed with Primary Pulmonary Hypertension (PPH)
I have undergone a Cardiac Catheterization
I have undergone a Lung Scan
I took or am currently taking Flolan

Have you ever been diagnosed with any of these additional conditions?

Unsure
Bacterial Endocarditis
Pulmonary Hypertension
Arrythimia
Atrial Fibrilation
Atrial Enlargement

Do you have any other information about Fen-Phen or your experience with the drug that you believe may be helpful for us to know? Please tell us more about yourself and your situation including:

Your Age, Current line of Work
Do you have your Fen-phen prescription records?
When was your last echocardiogram?
Do you have a copy of your echocardiogram report / videotape?
Do you have a Diet Drug Claim Number?
Did you file a Green Form? When? Do you have a copy?
What Level of compensation did you apply for?
Has your claim been audited or denied?
Have you received any money for the Settlement?
When is the best time to contact you?

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