How can we help you? Contact a medical attorney by completing the form below today or call 1.800.768.4026. Name Telephone Number Email Address What state do you live in Did you or a loved one experience worsening vision after receiving a Syfovre injection? Yes No Have you been diagnosed with any of the following conditions? Retinal vasculitis Retinal vascular occlusion Intraocular inflammation Blindness Other, explain below Tell us about your potential case (500 character limit) By submitting this form, I agree that Motley Rice LLC may collect my information and use it pursuant to its privacy policy. Yes No If you do not agree with our website privacy policy please call 1.800.768.4026 to discuss your potential case. CAPTCHA Math question 14 + 3 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. Leave this field blank