Qualified
Have you used Zantac (ranitidine) in the past?
*
Yes
No
Were you diagnosed with cancer after you started using Zantac (ranitidine)?
Yes
No
Select the type of cancer:
*
Select One
Bladder
Brain
Breast
Colorectal
Esophageal/Throat/Nasal
Kidney (Renal)
Liver
Lung
Pancreatic
Prostate
Stomach
Testicular
Other
See if You Qualify
Should be Empty: