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Heavy Metal Baby Food – Additional Information Needed

Heavy Metal Baby Food – Additional Information Needed

Heavy Metal Baby Food – Additional Information Needed

These additional questions are required by the court; you can see the approved Plaintiff Fact Sheet (a document we will have to submit when it comes time to file the case) here.

"*" indicates required fields

Your Name*
Child's Full Name (Note: If you have more than one and have already signed retainers for all, you'll need to complete one form for each child)*
1) Do you have credit, debit, WIC account, and/or banking statements that show purchases from any sellers identified in the Heavy Metal Baby Food Questionnaire? (Please note you'll have to provide them in case you answer Yes; this will benefit your potential claim.)*
4) Do you have any medical records or other documents that document the care provided to the child by any person or entity identified in the question above? (Please note you'll have to provide them in case you answer Yes; this will benefit your potential claim.)*
5) Has the child undergone testing for presence of or exposure to any heavy metal?*
7) Has the child participated in an investigative or other research trial relating to ASD or ADHD?*
9) Has the child, child's parent, or child's biological sibling undergone genetic testing?*
12) Are you a member of any of the below-mentioned brand membership rewards or subscription programs? (Select All that Apply):*
This field is for validation purposes and should be left unchanged.