About HRT Health Risks Legal Options FAQs To locate an attorney to evaluate your case, choose from a practice area below: Select an Area Business Law ------------------- Bankruptcy Business Law Contract Law Copyright Law Foreclosure Franchise Law Insurance Law International Law Mediation Mergers/Acquisitions Partnerships Patent Law Real Estate Law Trademark Law Consumer Law ------------------- Consumer Fraud Consumer Protection Debt Consolidation Lemon Law Unfair Debt Collection Unfair Trade Practice Criminal Defense ------------------- Criminal Defense Driving Violations Discrimination ------------------- Age Discrimination Civil Rights Disabilities Racial Discrimination Sex Discrimination Sexual Harassment Drug Litigation ------------------- Baycol Bextra Ephedra Fen Phen HRT PPA Rezulin Vioxx Employment Law ------------------- Employee Benefits ERISA Claims Retirement_Plans Whistle Blower Workers Comp Wrongful Discharge Estate Law ------------------- Elder Law Estate Planning Probate Admin Trusts Will Contests Family Law ------------------- Child Custody Child Support Divorce Law Government ------------------- Civil Litigation Immigration Law Military Law Health Law ------------------- Defective Hip Joints Lasik Litigation Medical Malpractice Nursing Homes Personal Injury ------------------- Brain Injury Car Accident Motorcycle Accident Personal Injury Trucking Accident Wrongful Death Stocks & Securities ------------------- Churning Investor Fraud Securities Fraud Unauthorized Trading Taxes ------------------- Tax Liens Tax Levies Tax Preparation Unpaid Taxes Toxic Products ------------------- Asbestos Lead Paint Mesothelioma Toxic Mold Welding Rods Transportation ------------------- Airplane Aciidents Admiralty Law Railroad Law Hormone Replacement Therapy Free Case Evaluation New Jersey Lawyers Please complete the form below to contact a Hormone Replacement Therapy Lawyer in New Jersey. 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: ALAKARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Zip Code: Home Phone: Work Phone: Cell Phone: Fax: Email: Did you take any of the following Combination Hormone Therapy Replacement drugs? Check all that apply. Drug    Year Started    Year Ended Prempro®    Unsure 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978    UnsureStill Taking 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 Premphase®    Unsure 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978    UnsureStill Taking 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 FemHRT®    Unsure 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978    UnsureStill Taking 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 None of the Above   Did you take any of the following Estrogen Only Hormone Therapy Replacement drugs? Check all that apply. Drug    Year Started    Year Ended Premarin®    Unsure 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978    UnsureStill Taking 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 Estradiol®    Unsure 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978    UnsureStill Taking 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 None of the Above   Did you take any of the following Progestin Only Hormone Therapy Replacement drugs? Check all that apply. Drug    Year Started     Year Ended Provera®    Unsure 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978    UnsureStill Taking 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 Medroxyprogesterone      Acetate (MPA)    Unsure 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978    UnsureStill Taking 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 None of the Above   Have you ever been diagnosed with any of the following cancers: Ductal Breast Cancer Lobular Breast Cancer Other Breast Cancer Ovarian Cancer Gall Bladder Cancer Non Hodgkins Lymphoma None of the Above Please identify when the condition you selected above was diagnosed? Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 If you were diagnosed with breast cancer, do you know if your Hormone Receptors were positive for Estrogen and or Progesterone? Unsure Receptors Positive for Estrogen and Progesterone Receptors Positive for Estrogen, Negative for Progesterone Receptors Positive for Progesterone, Negative for Estrogen Receptors Negative for Estrogen and Progesterone Please include any additional comments you might have. Please be sure to include: Your Date of Birth and Your Occupation The best time to call you. Daytime, Nightime, At Home or at Work? Any other information you believe is relevant to your situation including family medical history, whether or not you are a smoker, if you have ever had a hysterectomy, etc.

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