Dry Shampoo Cancer Lawsuit
Did you or a loved use Dry Shampoo?
Yes
No
Were you diagnosed with cancer?
Yes
No
What type(s) of cancer were you diagnosed with? Select all that apply.
Bladder
Breast
Colon and Rectal
Intestinal
Kidney
Liver
Lung
Myelodysplastic Syndromes (MDS)
Myeloproliferative Disorder (MPD)
Multiple Myeloma
Ovarian
Pancreatic
Prostate
Stomach
Testicular
Thyroid
Uterine
Other
Add any additional notes about your case you would like to discuss with our attorneys
State You Reside In
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State you reside in
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
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