You’re Not Alone. Let’s See If We Can Help.

If you developed Non-Hodgkin Lymphoma (NHL), Leukemia, or another type of cancer after being exposed to Roundup, you may be entitled to significant compensation. The information you share will help us evaluate your case.

Your answers are confidential. This form takes about 5 minutes to complete – the more detail you provide, the stronger your case.

Were you or a loved one diagnosed with a non-Hodgkin lymphoma? *

Did you/they develop Non-Hodgkin Lymphoma (NHL), Leukemia, or another type of cancer from Roundup exposure? *

Non-Hodgkin Lymphoma (NHL)

Leukemia

Other type of cancer

I'm not sure, show me a list

Has your loved one passed away? *

Yes

Thank you for your response. Since your loved one is still living, the family member must contact us directly to proceed. Please reach out to us at (800-315-3806)

Leukemia Types: *

Select the type of cancer from the list below: *

When were you first exposed to Roundup? *

When were you last exposed to Roundup? *

In what state did you primarily use Roundup? *

Please describe ALL of your direct exposure to RoundUp including the years you used it: *

When were you diagnosed? *

What is the name of the doctor that diagnosed you? *

At what facility were you diagnosed? *

At which state were you diagnosed? *

Full Name *

Phone *

Gender *

Address

Street Address *

City *

State *

Postal Code *

By submitting this form, I agree to Levy Konigsberg LLP’s Terms and Conditions and Privacy Policy, and consent to receive communications from Levy Konigsberg LLP via calls, text messages, emails, or other methods necessary for processing my potential case or contacted any other matter. Message frequency may vary, and msg & data rates may apply. Reply STOP at anytime to cancel. I understand that these communications may be made using automated systems.