Indicates required field Connect with a Teen Social Media Harm Lawsuit attorneyThis form will help you get in touch with our staff about Teen Social Media Harm Lawsuit. If you have any questions, please complete this form or call 1.888.425.2020. Not the case you were looking for? Start a new form here. 1 Contact Information Tell us about yourself. 2 Case Details What should we know about your case? 3 Completion Thank you for reaching out! Full Name Email Phone State State/Province Select your state of residenceAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Next Have you or a loved one developed a brain disorder, such as encephalitis or meningoencephalitis, after taking Zinbryta? Yes No Did you take Zantac and/or a generic version? Yes, prescription Zantac only Yes, over-the-counter Zantac only Yes, generic only Yes, a mix of both No I'm not sure Have you been diagnosed with any of the following after taking Zantac? Stomach cancer Bladder cancer Pancreatic cancer Liver cancer Esophageal cancer Other injury, explain below No injury Did you or a loved one consume recalled WanaBana Apple Cinnamon Pouches? Yes No Have you or a loved been diagnosed with lead poisoning after consuming the product? Yes No Have you experienced serious health issues associated with transvaginal mesh? No Yes Have you had one or more revision surgeries as a result of mesh? No Yes What state did your accident occur in? When did your accident occur? Have you or a loved one been diagnosed with a debilitating injury after taking PPIs? Acute interstitial nephritis Chronic kidney disease Kidney failure Other, explain below No diagnosis Were you exposed to per- and polyfluoroalkyl substances (PFAS) "forever chemicals," either through aqueous film-forming foam (AFFF) or another source? Choose all applicable. Yes, exposed as a fire fighter to foam Yes, exposed as a fire fighter to bunker gear Yes, exposed through water consumption Yes, exposed through another source. Explain below No Were you diagnosed with any of the following conditions after exposure? Kidney cancer Liver cancer Testicular cancer Thyroid Cancer Thyroid disease Ulcerative colitis Year of diagnosis: Do you rent/own property or a business that was impacted by the Norfolk Southern train derailment? Yes No Type of property Do you own any livestock that have incurred medical expense or have passed away as a result of Norfolk Southern train derailment? Yes No Are you experiencing any new medical conditions or injuries since the train derailed? Yes No Type of injury Were you implanted with a metal-on-metal hip replacement device? Yes No What type of insulin pump do you use? 600 Series Medtronic MiniMed Insulin Pump - Model 670 G 600 Series Medtronic MiniMed Insulin Pump - Model 640 G 600 Series Medtronic MiniMed Insulin Pump - Model 630 G 600 Series Medtronic MiniMed Insulin Pump - Model 620 G I'm not sure Other, explain below Pain Pumps We are not handling pain pump cases. We are not interested in non-U.S. claims. Have you experienced any of the following side effects? Brain injury Coma Seizure Loss of consciousness Death Other injury, explain below No injury Have you had a retrievable IVC filter surgically implanted after Jan. 1, 2003? Yes No Have you experienced any side effects? Select all that apply Additional surgeries Detached device components Device fracture Device migration/tilting Vein or organ perforation Irretrievable device Other, explain below Have you or a loved one been victim to human trafficking? Yes No What state did the trafficking take place? When did the trafficking take place? How old were the people being trafficked? What business or entity facilitated the trafficking? Were you or a loved one harmed by Hamas? Yes No Only certain people are allowed to bring a claim using these laws. Are you a: U.S. National The family member of a U.S. National U.S. Servicemember U.S. Government Contractor Make and Model Dodge Charger Chrysler 300 Jeep Grand Cherokee Maserati Quattraporte or Ghibli Model Year - Select -2012201320142015 When did your accident occur? What state did your accident occur in? Do you believe your insurance company has charged you more than the actual cost of medical services or products? Yes No Do you suffer from shortness of breath, a chronic cough, or wheezing Yes No Have you been diagnosed with lung disease Yes No Have you been exposed to chemical flavoring from food products or from e-cigarettes Yes No Have you been burned or injured by a defective device? Yes No Were you implanted with a Exactech hip, knee or ankle replacement? Yes No Did you take Elmiron? Yes No I'm not sure Have you experienced any of the following side effects after taking Elmiron? Change in eye color Blurred vision Difficulty reading poor light to dark vision adaptation Dark spots in vision Straight lines appear curved Less vivid colors in your vision Pigmentary maculopathy Other injury, explain below No injury Have you had an endoscopy between Jan. 1, 2010 and Oct. 31, 2015? Yes No Were you injured by an EFP in Iraq between the Fall of 2005 and December 2012? Yes No Do you use a Dexcom device and Dexcom App? Yes, Dexcom G6 Yes, Dexcom G7 Yes, another Dexcom product No, a different product Have you experienced any of the following side effects? Brain injury Coma Seizure Loss of consciousness Death Other injury, explain below Have you or a loved one been injured in an accident where your vehicle failed to perform as the manufacturer intended? Yes No When did the accident occur? What state did your accident occur in? Have you been diagnosed with Parkinson’s Disease? Yes No How were you exposed to paraquat? I was a licensed applicator I worked for a licensed applicator Other, explain below Have you or a loved one been victim to childhood sexual abuse? Yes No What state(s) were you or your loved one abused in? When did the abuse take place? How old was the person or people being abused? Date of birth of the person who was abused What group or institution facilitated the abuse? Was a family member the perpetrator of the abuse? Yes No Have you been exposed to hair relaxer products and diagnosed with uterine, ovarian or endometrial cancer? Yes No Were you injured on a plane or in an airport or other transportation facility? Yes No Did your injuries require significant medical treatment or hospitalization? Yes No Were you arrested and jailed in an airport or other transportation facility? Yes No Were you released without charges, prosecution, guilty pleas, or convictions of charges? Yes No Have you been exposed to Roundup products and developed non-Hodgkin lymphoma (NHL)? Yes No Where were you exposed to Roundup? At home (residential use) At work (occupational use) What year were you diagnosed with NHL What time period were you at Camp Lejeune? In what capacity were you at Camp Lejeune? Served with U.S. Armed Forces Service member spouse or family member Government contractor Other… Enter other… Were you or a loved one diagnosed with any of the following health complications? Aplastic Anemia Cancer, Bladder Cancer, Kidney Cancer, Liver Cardiac birth defect Leukemia Multiple Myeloma Myelodysplastic Syndromes Non-Hodgkin’s Lymphoma Parkinson’s Disease Other kidney disease/end stage renal disease Systemic Scleroderma or Systemic Sclerosis Other, explain below Are you a parent who is filing for your minor child (under 18 years old)? Yes, I am filing for my minor child (under 18 years old) No, I am over 18 years old and filing for myself Current age of the child Your current age Have you or your child been diagnosed with the following that you believe was influenced by social media? Anxiety Eating Disorders Depression Self-harm Suicidal activities/ideation Have you or your child been diagnosed with the following that you believe was influenced by social media? Anxiety Eating Disorders Depression Self-harm Suicidal activities/ideation Did Instagram contribute to the diagnosis or injury? Yes No Which social platform(s) contributed to the diagnosis or injury? (Check all that apply) Instagram Tiktok Snapchat Facebook YouTube Other… Enter other… Did your child begin using social media before age 10? Yes No Age when social media use started Age when social media use started - Select -12345678910111213141516171819202122232425 or older Age at injury or diagnosis - None -12345678910111213141516171819202122232425 or older Age of diagnosis or injury Were you exposed to per- and polyfluoroalkyl substances (PFAS) "forever chemicals," either through aqueous film-forming foam (AFFF) or another source? Choose all applicable. Yes, exposed as a fire fighter to foam Yes, exposed as a fire fighter to bunker gear Yes, exposed through water consumption Yes, exposed through another source. Explain below No Were you diagnosed with any of the following conditions after exposure? Kidney cancer Liver cancer Testicular cancer Thyroid Cancer Thyroid disease Ulcerative colitis Year of diagnosis: Did you use artificial tears and subsequently suffered from vision loss? Yes No Which artificial tear product(s) did you use? EzriCare® Artificial Tears Delsam Pharma® Artificial Tears Lubricant Eye Drops Other What state did your accident occur in? When did your accident occur? Have you been diagnosed with an asbestos-related disease? Mesothelioma Lung Cancer Other diagnosis, explain below Do you own 2011-2015 model Audi or Volkswagen with a 3.0 Liter TFSI engine? Yes No Make & Model Audi A4 Audi A5 Audi A5 Cabriolet Audi A6 Audi A7 Audi A8 Audi Q5 Audi Q7 Volkswagen Touareg 3.0-Liter Hybrid Model Year - Select -20112012201320142015 Vehicle Identification Number Did your child develop NEC after consuming cow milk-based formulas? Yes No Did your baby develop complications after consuming a recalled product made by Abbott Nutrition? Yes No Do you have evidence your child consumed a recalled formula? Yes No Did you take Belviq and/or a generic version? Yes, Belviq only Yes, generic only Yes, a mix of both No I'm not sure Have you been diagnosed with any of the following after taking Belviq? Pancreatic cancer Colorectal cancer Lung cancer Other injury, explain below No injury Medical Device - Select -Breast Implants (BIA-ALCL)CPAPKugel MeshEndoscope/DuodenoscopeHernia MeshInsulin PumpsLaparoscopic Power MorcellationParagard IUDSurgical StaplersTransvaginal/Pelvic Mesh (TVM)Other Medical Device - Select -Breast Implants (BIA-ALCL)CPAPKugel MeshEndoscope/DuodenoscopeHernia MeshInsulin PumpsLaparoscopic Power MorcellationParagard IUDSurgical StaplersTransvaginal/Pelvic Mesh (TVM)Other Medical Drug or Product - Select -BelviqElmironOxbrytaProton Pump InhibitorsSyfovreTalcum PowderTestosterone Replacement TherapySteriCare Sterile Water & Saline SolutionsXeljanzZantacOther, explain below Did your loved one consume baby food on a regular basis from one of the following manufacturers: Happy Family Organics (HappyBABY); Beech-Nut Hain Celestial Group (Earth’s Best Organic Gerber Campbell (Plum Organics) Wal-Mart (Parent’s Choice/Parent’s Choice Organics); or Sprout Organic Foods Do you still have any of these products? Yes No Has your loved one been diagnosed by a medical professional with Autism Spectrum Disorder (ASD) Attention Deficit Disorder (ADD) Attention-Deficit/Hyperactivity Disorder (ADHD) Was that diagnosis before the age of 14 years old? Yes No Did you have a breast implant procedure? Yes No Have you been diagnosed with breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)? Yes No Did you use talcum powder? Yes No Have you been diagnosed with ovarian cancer after talcum powder use? Yes, ovarian cancer No, other injury No, no injury Which GLP-1 RA product did you take? A compounded version Mounjaro only Ozempic only Rybelsus only Saxenda only Trulicity only Victoza only Wegovy only Zepbound only Other, explain… Enter other product(s)… Which GLP-1 RA product(s) did you take? A compounded version Mounjaro Ozempic Rybelsus Saxenda Trulicity Victoza Wegovy Zepbound Foundayo Other… Enter other… What year did you begin taking a GLP-1 RA product? Are you still taking a GLP-1 RA product? Yes No When did you stop? Have you been hospitalized or required medical care for any of the following conditions? Blood Clots deep vein thrombosis (DVT) gastric distress Intestinal obstruction severe or permanent stomach paralysis necrotizing pancreatitis pancreatic cancer pulmonary embolism surgical complications vision changes or loss Did you use a telehealth provider (e.g., Noom, Hims/Hers, Ro, etc.) to get your prescription Yes No Have you or a loved one had a hernia surgically repaired using mesh? Yes No Did you have problems following the initial hernia surgery? Regular pain or discomfort Device migration Bacterial infections Additional surgeries Other, please explain... Enter other problems… Was the initial hernia surgery after January 1, 2000? Yes No Have you had a hernia revision surgery because of faulty hernia mesh, not hernia reoccurrence? Yes No Medical Drug - Select -BelviqElmironProton Pump InhibitorsSJS Associated DrugsTalcum PowderTestosterone Replacement TherapyOzempicSyfovreXeljanzWegovyZantacOther, explain below Have you been implanted with a Paragard IUD? Yes, just one Yes, multiple implants No Have you experienced any side effects? Select all that apply IUD BREAKAGE UPON REMOVAL SURGERIES, INCLUDING HYSTERECTOMY INFERTILITY DEATH Have you had a hysterectomy or another surgery to remove this device? Yes No Did you use Depo-Provera or a related product? Yes, Depo-Provera Yes, Depo-SubQ Provera Yes, an authorized generic medroxyprogesterone acetate birth control shot Did you develop meningioma (a type of brain or spinal tumor) after taking this medication? Yes No When did you begin using this medication? How many injections of this medication did you receive? Did you lose an embryo during an IVF procedure that used CooperSurgical IVF fluid? Yes No Have you or a loved one experienced a serious injury that resulted in medical expenses, loss of income, long-term care or rehabilitation? Yes No Have you been diagnosed with an injury following exposure to a contamination of your home, health or the environment? Yes No Were you or a loved one pregnant while living near or working on a farm that applied DCPA? Yes No Did the child from that pregnancy suffer from any birth issues, neurological deficits or low birth weight? Yes No Have you or a loved been diagnosed with lead poisoning after exposure to lead? Yes No What type of fraud? CFTC IRS SEC Qui Tam Other… Enter other… Have you or a loved one been victim to human trafficking? Yes No I have other information Where did the trafficking take place? When did the trafficking take place? How old were the people being trafficked? What business or entity facilitated the trafficking? Which Sony PlayStation consoles did you purchase? PlayStation 4 PlayStation 5 (disc) PlayStation 5 Digital Edition Where did you purchase digital games? I only purchased digital games from the PlayStation Store I only purchased digital games from other retailers I purchased digital games from both the PlayStation Store and other retailers Do you have receipts for your PlayStation digital game purchases from a retailer? Yes No Did you or a loved one suffer an infection after an endoscopy? Yes No Have you had a surgery in the breast region where a surgical mesh product was used? Yes No Do you know the name of the product used in your surgery? Phasix™ Mesh Phasix™ ST Mesh Phasix™ Plug and Patch Phasix™ ST Mesh with Open Positioning System (OPS) Phasix™ ST Mesh with Echo 2™ Positioning System GalaFLEX Lite™ Scaffold GalaFLEX™ Scaffold GalaFLEX 3D™ Scaffold GalaFLEX 3DR™ Scaffold I do not know the product Which side effects did you experience after the mesh was placed? Abscess or chronic fluid buildup Additional surgeries Deformity Infection Mesh migration or displacement Pain Tissue loss Were you diagnosed with cutaneous T-cell lymphoma after taking Dupixent? Yes No Medical Drug - Select -BelviqElmironProton Pump InhibitorsSJS Associated DrugsTalcum PowderTestosterone Replacement TherapyOzempicSyfovreXeljanzWegovyZantacOther, explain below Have you or a loved one been diagnosed with skin cancer after using a UV gel nail dryer? Yes No Did the cancer originate on your fingers, toes, or the surrounding skin? Yes No Provide some information about your potential case By submitting this form, I agree that Motley Rice LLC may collect my information and use it pursuant to its privacy policy. I agree Yes Go Back Leave this field blank FAQs & Additional Resources Will I have to put up any money to get started? Our initial consultation is always free. Most cases use a contingent fee contract, meaning we do not get paid until or unless our clients make a recovery. This contingent fee will be a percent of the recovery, calculated before deducting expenses. In some circumstances, a retainer agreement may include representation on an hourly basis. However, we recommend speaking with an attorney to learn more. What do you need to know about my potential case? When someone from our law firm speaks with you, we'll need to gather some basic information about your case. This can include names and dates, as well as a timeline relating to the claim. The more information you can provide, the better. Where does Motley Rice handle cases? Motley Rice represents clients across the globe. We litigate cases in all 50 states, as well as internationally. We are comfortable working along with co-counsel if needed. What can I do if I'm not sure that I'm completing the right form? We understand that it may feel overwhelming trying to get all of the details right. If you're unsure that you're completing the right form, please call 1.800.768.4026. Our staff can work with you to understand your claim and do what we can to help. Additional Resources Litigation Areas All Cases FAQs About Us Attorney Hub