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FREE HAIR RELAXER CASE EVALUATION 
There are no fees or expenses unless a settlement or recovery is obtained.

Are you filling the form out for yourself or a loved one?
Myself
A Loved One
What is the date of birth of you or your loved one?
Did you or someone you know use hair relaxers?
Yes.
No.
How many times per year was the chemical hair product(s) used?
Which, if any, of the following conditions were you or your loved one diagnosed with after using chemical hair straighteners?
What type of chemical hair products were used? (select all that apply)
What year were you or your loved one diagnosed?
Do you already have an attorney?
Yes.
No.

Please contact your attorney concerning this matter.

Has your loved one had a BRCA gene test?
Please select any surgeries or treatments that have been performed or are scheduled.
Please enter the date of the surgery or treatment.
Select any birth or fertility issues that occurred after treatment?
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State

Unfortunately, your case does not meet our selection criteria.  We encourage you to continue seeking counsel for your matter.

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