This form takes about 1-3 minutes to complete. You may be entitled to significant compensation.

Did you or your child use any of the following platforms: Instagram, Facebook, TikTok, Snapchat, or YouTube? *

What is your/your child's username/handle on the app(s)? *

You/your child's current age: *

How old were you/your child when they first began using social media? *

Approximately when did you/your child start using the app(s)? *

On average, how many hours per day were spent on these platforms? *

Has the claimant ever been diagnosed with Borderline Personality Disorder (BPD)? *

Have you or your child received medical treatment for these conditions? *

When did the condition(s) start? *

What is the treatment provider's name? *

In what city and state was treatment recieved? *

When did the treatment occur? *

Estimated dates are acceptable...

Do you have a valid U.S. Social Security Number? *

Are you currently being represented by an attorney or another law firm for this matter? *

Your information is 100% confidential and only shared with our legal team. You pay nothing unless we recover compensation for you.

Full Name *

Phone *

Email *

Date Of Birth *

Gender *

Address

Street Address *

City *

State *

Postal Code *

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