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Free Case Evaluation

FREE LEVAQUIN CASE EVALUATION

NOTE:  This Case Evaluation form can also be completed for situations that involve other fluoroquinolone antibiotic medications such as Avelox and/or Cipro -- even if there is no Levaquin involved. 

We suggest you use our new Levaquin / Cipro / Avelox Drug Injury Case Evaluation, instead.


Our law firm represents people in personal injury cases that involve adverse medical events caused by Levaquin such as the following:

  • Peripheral Neuropathy
  • Serious Nerve Damage
  • Retinal Detachments
  • Liver Failure
  • Liver Disease / Injury
  • Drug-Induced Hepatitis

Please be assured that the information you provide to our law firm when completing this legal case evaluation form will be treated by us as strictly confidential.  You will get a reply from us no later than the next business day.  Submitting a case evaluation does not obligate you to hire our law firm for your lawsuit.  We handle all cases on a contingency fee basis, which means that you will make no payment for our legal services until after we have succeeded in getting legal compensation for you.

 

NOTE: We are no longer taking cases involving:

  • Tendon Rupture
  • Rotator Cuff Tear / Injury
  • Severe Tendonitis / Tendinitis

 


Personal Information

*Required Fields

*Your Name:

*E-mail:

Street Address:

City:

State:

Zip:

*Phone Number:

Best time to call: DayNight


Case Facts

1. Have you, a family member, or some other person you know suffered a serious side effect caused by Levaquin? YesNo

If yes, please indicate which condition(s) the doctor diagnosed; check all that apply:

Peripheral Neuropathy
Serious Nerve Damage
Retinal Detachments
Liver Failure
Liver Injury
Liver Disease
Drug-Induced Hepatitis
Other adverse side effect:

2. What was the date of the initial diagnosis of the Levaquin side effect?

3. Approximately when was Levaquin used (month/year)?

4. What dosage of Levaquin was prescribed, if known?

5. Is this for you or someone else, and if it is for someone else, what is his or her relationship to you?
MeSomeone Else
Relationship:

6. What is the date of birth of the person who had an adverse reaction to Levaquin?

7. Has a lawsuit been filed concerning the Levaquin side effect: YesNo


Is there any additional information you would like to include?

Please enter any additional information about this claim, as well as any comments or questions you may have, in the following space:



  • US FDA advises that you should not stop taking any prescription medication before talking to your doctor.
  • Reports of serious drug side effects should be made to the US FDA MedWatch program.
  • The prescription drug names are registered trademarks of the respective drug companies.
  • DrugInjuryLaw.com is not affiliated with any of the drug companies, nor US FDA.
Law Offices of Thomas J. Lamb, P.A.
Lumina Station Suite 225
1908 Eastwood Road
Wilmington, NC 28403
Tel: (910) 256-2971   Fax: (910) 256-2972
Toll Free: (800) 426-9535
email: ThomasJLamb@DrugInjuryLaw.com

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