We handle cases that change lives. Please fill out the form below to see if you qualify. Name* First Last Phone*Email* Were you prescribed Suboxone film for at least 6 months?* YES NO Did you use Suboxone pill or film?* Pill Film Both Did you experience any of the following dental injuries as a result of your Suboxone use: cavities, tooth loss, tooth fractures, tooth decay, tongue injuries, gum injuries YES NO Did you ever visit a dentist prior to Suboxone use? YES NO State where the dental damage startedSelect StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWhat State do you live in? We are currently not accepting clients in Texas, Michigan or TennesseeSelect StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingThanks for your interest! We are sorry, but based on your answers, it looks like we are unable to help you.HiddenContent-type Hiddenweb source HiddenCase Type HiddenQuestion 1 HiddenQuestion 2 HiddenQuestion 3 HiddenQuestion 4 HiddenIf_API_Generated Hiddenwebsource HiddenPrimaryPhone PhoneThis field is for validation purposes and should be left unchanged. Δ
