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Learn if You Have a Claim Against Paxil, Prozac, Zoloft, Lexapro, Celexa, Effexor, Wellbutrin (anti-depressant manufacturers)

Commonly-Prescribed Antidepressants Are Extremely Dangerous for Some Kahn Gauthier Swick is investigating possible legal actions against the makers of Paxil, Prozac, Zoloft, Lexapro, Celexa, Effexor, and Wellbutrin, respectively, to recover for suicides or homicides--some completed, some only attempted--by patients in the first few days or weeks after they were prescribed one of these drugs.
Claimant Information
Are you submitting this information on behalf of yourself?	Yes  No
Are you submitting this information on behalf of a family member?	Yes  No
If yes, please provide: Name of injured party:
Relationship to injured party:
Injured Party Information
Date of Birth:
Marital Status:
Number of Children:
Employment Status:
Salary:
Anti-depressant Use
Which anti-depressant drug was taken?
Date you began taking the drug
Date you stopped taking the drug
Why was the Anti-depressant prescribed?
Amount prescribed and any changes in dose:
Medical Information
Did the anti-depressant user commit or attempt suicide?	Yes  No
If yes, please describe the circumstances regarding the suicide or suicide attempt.
Date of suicide or attempt:
City & State in which suicide or attempt occurred:
Did the anti-depressant user attempt suicide prior to the use of the anti-depressants?	Yes  No
If yes, please explain:
Prior history of depression:
List all other drugs taken at the time of the suicide or attempt:
Other
Are you presently covered by health insurance?	Yes  No
Have you previously retained an attorney to represent you in this matter?	Yes  No

Personal Information
	First Name
	Last Name
	Street / Apt	/
	City, State Zip	-- AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AA AE AP AB BC NB NF NT NS ON PE QC SK YT AS GU MB MH FM MP PW PR VI OT
	Home Phone & Evening Phone (Same)	. . & . .
	E-Mail Address
	Confirm E-Mail
	Date Issue/Problem	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

	Terms & Conditions I acknowledge that I have read and understand and agree to the following legal policies.
	Certain features of Lawcash.com require a login - please simply choose a password to continue. Password Confirm Password I'd like to become a Lawcash.com member, receive a free class action ebook, and free class action and recall alerts. Billions of dollars are available each year and I'd like to claim my fair share from bad corporations.
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