ANTIDEPRESSANT CLAIM FORM
 


If your child has demonstrated unusual or extreme behavior, or attempted or committed suicide following the use of an antidepressant medication, please fill out the form and a lawyer will review your information within a few days. It is important to act immediately. All states have laws limiting the time to file a claim.

Name:
Address:
City:
State:
Zip:
Day phone:
Evening phone:
Email Address:
 
Age of Antidepressant User:
Name of Antidepressant/drug:
User attempted or committed suicide?

User demonstrates highly unusual or extreme behavior?

How long on antidepressant medication?

How long after first use of antidepressant medication did behavior first occur?
Describe Injury/Problem:  

 

 

  

 

 

AntidepressantSuicide.com is a consumer and lawyer information resource
about antidepressant suicide warnings and lawsuits.