Roundup Cancer Lawsuit

All fields marked * are required. Your answers are protected under attorney privilege.

Have you personally used Roundup weed killer or another glyphosate herbicide *

Yes

Were you ever diagnosed with Non-Hodgkin lymphoma or another blood cancer? *

Yes

Not sure

In what year were you diagnosed? *

Did the diagnosis occur after you began using Roundup? *

Yes — I have records

Possibly — need to request

Not

Not sure

Do you have medical documentation confirming the diagnosis? *

Yes

Not Sure

Do you have proof of Roundup use? *

Yes — I have prescription records

Possibly — need to request

Not sure

Are you currently undergoing treatment or monitoring for the cancer? *

Yes — active treatment

Yes — monitoring only

No — treatment completed

No — never treated

Your Contact Info

Full Name *

Email *

Phone *

State of Residence *

Anything else you'd like us to know?

I consent to receive communications from Hackett Law Firm about this case and related investigations. *