Contact Us
Share With A Friend
Van Robichaux Trial Attorney Renee Robichaux Attorney At Law
 
Free Nationwide Case Evaluation
 
General Information
First Name
Last Name
City
Zip Code
State
Country
Primary Phone ( ) - -
Alternate Phone ( ) - -
E-Mail Address
 
Accutane Use
Date you last used Accutane:    

Medications Used
Accutane
Generic Accutane : Amnesteem, Claravis, and/or Sotret.

Diagnosis
Inflammatory Bowel Disease
Ulcerative Colitis
Crohn's Disease
Other

Approximately what year was the diagnosis by a medical professional?    

Please describe the nature and extent of your injuries resulting from your use of Accutane:

Questions / Comments:
 
Terms & Conditions
I have read and understand this paragraph.

Please be advised we do not and cannot represent you until we have had an opportunity to evaluate your potential claim. After we have reviewed your medical records to determine whether you appear to have Accutane-related injury or injuries, we will send you a contract for representation. Until such time as we have a signed contract of representation from you, we do not represent you in any claim related to your use of Accutane. Please be advised that your lawsuit is subject to a strict statute of limitations. If you do not file a lawsuit prior to the expiration of the statute of limitations, you will be forever barred from pursuing any claim related to your use of Accutane. Your statute of limitations may have already expired and, if it has not, each day that passes brings you closer to the expiration of the statute of limitations. Thus, you need to act immediately in filling out the above questionnaire. We do not represent you until we have received a fully executed fee agreement.