Product Injury Information Center

Products Liability Contact Form

Name

Email Address

Phone Number

What was the product that injured you?

How did you come to use or otherwise be in contact with the product?

Where did you purchase it?

Did any written documentation or warnings accompany the product?

When was the product purchased?

Is or was the product ever under warranty?

Did the salesperson make any representations, statements or promises, regarding the product's performance?

Had you experienced problems with the product prior to your injury? Were they similar to the problem that occurred when you were injured?

Had the product in question ever been altered?

Had the product in question ever been repaired or serviced? When? Where? Why?

When did the injury occur? How did it occur?

Did a health care professional treat the injuries? When? Prognosis?

How has the injury altered your lifestyle?

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