Breast Mesh

Breast Mesh Questionnaire

Please answer the following questions as accurately as you can. If you do not know an exact product name or date, provide the information you currently have.

Questionnaire

Breast Mesh Claim Questionnaire

Thank you for allowing Aylstock, Witkin, Kreis & Overholtz to handle your Breast Mesh claim. This litigation involves complex medical and legal issues, and we write you now to briefly introduce you to our firm.

As we move ahead with the investigation stage of your case, the first step in the process is for us to gather detailed information about your claim and medical history. To do that, we will need your assistance. We have created a questionnaire that we ask that you carefully review and answer as thoroughly and completely as possible.

If there is a question within the questionnaire that you do not know the answer to, such as doctor or facility names, please state that you do not know rather than leaving it blank.

Regarding dates, please be as specific as possible, even if the answer is vague (i.e., “within the last 5 years”, or “between 2010 and 2012”, etc.). We will be using certain answers you provide to order your medical records and need this information to do so.

We ask that you please submit this questionnaire to us within fourteen days of the date of this letter. If for some reason you are unable to complete the questionnaire within that time period or need assistance completing it, please contact the Breast Mesh team by phone (877-810-4808) or via email (BreastMeshDept@awkolaw.com).

Thank you for trusting us with you Breast Mesh claim. We look forward to working with you.

What Information May Be Needed During the Review?

The initial online questionnaire is designed to collect basic information about your experience. If your claim moves forward for additional review, the legal team may later request more detailed information, including:

Product Information

The brand or manufacturer of the breast mesh, if known.

Implant Information

The approximate date of the initial breast mesh procedure and the doctor who performed it.

Removal or Revision Information

Whether the mesh was removed or whether other procedures were required.

Injury Information

The complications or medical problems experienced after implantation.

Medical Providers

Doctors or hospitals that treated the reported injuries.

Find Out Whether Your Breast Mesh Claim May Qualify

The first step is answering a few questions about your procedure and the complications you experienced.

Submitting the questionnaire does not guarantee that your case will be accepted.