Zofran Claims Compensation Evaluation Form

* Did you or a loved one take Zofran while pregnant?
- Yes
- No

* Why was Zofran (ondansetron) prescribed?
- Nausea
- Other

* How long was medication used during pregnancy?
- 1st trimester
- 1st and 2nd trimester
- 1st, 2nd and 3rd trimester

* Child's Year of Birth*

* Based on your responses, you may qualify for compensation! Please provide additional comments to help evaluate your case. (Required)

Your evaluation is almost complete. You may be entitled to compensation! If you or a loved one has taken Zofran and have a child who has suffered a birth defect, we encourage you to contact an experienced legal professional today to evaluate your possible legal rights. The call is free and we only get paid if we collect financial compensation for you. To learn more, please enter your contact information. You can also call us toll free at (800) 214-1010
First Name*
Last Name*
Email*
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Address*
Street Address City State ZIP Code
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