Nationwide Januvia® Lawsuit

Houston
3200 Travis : 3rd Floor
Houston, TX 77006
(713) 529-0025
(713) 751-0412 (fax)

Galveston
(409) 762-9090

Toll Free
888-529-4688

andrewsteinberg@lawyer.com
www.thesteinberglawfirm.com

Januvia

Free Case Review

Fill out the form below if you need additional information or want to discuss a potential claim with an attorney. All inquiries are kept strictly confidential.

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Contact Information
* Title:
* First Name:
* Last Name:
* Relationship to Januvia User:
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Case Information
Name of Januvia User:
Date of birth of Januvia User (mm/dd/yyyy):
Age of patient when Januvia was prescribed:
Did you or a loved one experience any of the following side effects after taking Januvia?
Severe upper abdominal pain which may radiate through the back
Nausea and Vomiting
High or Low Blood Pressure
Elevated Heart or Respiratory Rates
Pancreatic Cancer
Death

What medical treatments have you had due to complications of using Januvia?
Did any of the side effects result in death?
Yes
No
Was hospitalization or institutionalization required after taking Januvia?
Yes
No

Were you on Januvia at the time of hospitalization?
Yes
No
When did this occur?