Invokana Injury Claims Form

* Were you (or a loved one) hospitalized as a result of the injury specified?
- Yes
- No

First Name*
Last Name*
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- By leaving this box checked, I agree that the information viewed is advertising and that you agree to receive future advertisements from Hood National Law Group and/or its partners.
- I agree that submitting this form and the information contained therein does not establish an attorney client relationship.
- I agree that the information submitted will be reviewed by more than one attorney and/or law firm.
- I agree that the information that I will receive in response to the above question is general information and I will not be charged for the information. I further understand that the law for each state may vary, and therefore, I will not rely upon this information as legal advice. Since this matter may require advice regarding my home state, I agree that local counsel may be contacted for referral of this matter.
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Invokana Lawsuit Claim Form