Center: Legal Aid
If you would like more information about Mesothelioma, legal help
or the availability of treatment payment options fill out the
information below for a no-cost assessment of your rights to
a compensation package.
The information you submit will be kept private and confidential
and used for the sole purpose of evaluating your claims for compensation
or eligibility for money to pay for treatment.
All submissions are completely confidential
Items marked with a * are required. Thank you.
*Phone Number (day):
What is the Injured's
relationship to you?:
Injured's Date of
(ie . mm/dd/19yy)
Have you or they
been diagnosed with mesothelioma?: