Contact the Settlement Administrator

Using the form below, please provide us with your contact information and the nature of your request.

Contact Information:

Please select what type of Class Member you are:*

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Request Type:

Please select your request type:

  • I would like to receive notice of updates to this case.
  • I would like confirmation if I am a Class Member.

Please provide the following additional information to help confirm if you are a Class Member.

Name of Provider:
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Estimated Amount Paid:
$
Start Date of Treatment:
End Date of Treatment:

Note: If you do not know the exact dates, please provide your best estimate.