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Ruhmann Law Firm


New Mexico 

Talcum Powder

Talcum Powder Fillable Intake

  • Date Format: DD slash MM slash YYYY
  • (If Injured Person Is Deceased)

  • Date Format: DD slash MM slash YYYY
  • 1. Have you been diagnosed with Ovarian cancer, Fallopian cancer, or Mesothelioma?
  • (If none, decline the case.)
  • 2. Have you been diagnosed with prior breast cancer or other gynecologic cancers?
  • 3. Other than the cancers previously discussed, have you been diagnosed with any other form of cancer?
  • 4. Do you have an immediate family history of Ovarian cancer or breast cancer?
  • 5. Have you had a BRCA test?
  • (If yes, and positive for genes 1 and 2, decline case.) (If BRCA has not been taken or test if positive for other than genes 1 and 2, continue intake.)
  • 6. Has the injured party suffered with infertility?
  • 7. Which powder product did you use?
  • (If usage was less than 5 years before diagnosis, decline.)
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