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Submitted URL: https://storage.googleapis.com/lowsss/kembibi.html#y5fysl.uHmWKjzFWnBHX?dzqTtmcckTLjcwMdYcdcC0cpc1DVBfpqzcbbb4x
Effective URL: https://lawsuit-winning.com/paraquat3/?campaign_id=311&crid=240723301&afid=602&cid=31613&sid1=4356&sid2=386380840&sid3=2_311...
Submission: On October 25 via api from BE — Scanned from DE
Effective URL: https://lawsuit-winning.com/paraquat3/?campaign_id=311&crid=240723301&afid=602&cid=31613&sid1=4356&sid2=386380840&sid3=2_311...
Submission: On October 25 via api from BE — Scanned from DE
Form analysis
1 forms found in the DOMPOST submit.php
<form id="main_form" method="post" action="submit.php" class="form-horizontal ">
<fieldset class="pb-1 pb-md-0">
<div class="row form-group mb-0 ">
<div class=" col-md-6">
<input vtype="not_empty" type="text" class="form-control form-control-lg " id="edit_firstname" name="edit_firstname" placeholder="First Name" value="" required="" minlength="3">
</div>
<div class=" col-md-6">
<input vtype="not_empty" type="text" class="form-control form-control-lg" id="edit_lastname" name="edit_lastname" placeholder="Last Name" value="" required="" minlength="3">
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<div class=" col-md-6">
<input type="email" id="edit_email" name="edit_email" placeholder="Email" class=" form-control form-control-lg " value="" pattern="^([\w\.\-]+)@([\w\-]+)((\.(\w){2,3})+)$" required="" data-required="true">
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<div class=" col-md-6">
<input type="tel" id="edit_phone" name="edit_phone" class="form-control form-control-lg" placeholder="Phone" data-val="true" value="" pattern="^[\(]?[2-9]{1}[0-9]{2}[\)]?[.\- ]?[2-9]{1}[0-9]{2}[.\- ]?[0-9]{4}$"
data-val-regex="Please enter a valid number" data-val-required="Phone is required." required="" data-required="true">
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<div class=" col-md-6">
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<div class=" col-md-6">
<input vtype="zip" type="text" class="form-control form-control-lg" id="edit_zip" name="edit_zip" placeholder="Zip" value="" required="" maxlength="5" minlength="5" pattern="^\d{5}$" data-val-regex="Please enter a zip code"
data-val-required="Zip is required.">
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<div class="row mb-0 ">
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</fieldset>
<hr class="mt-2 mb-1" style="border-bottom: 1px solid white;">
<div class="container">
<div class="row form-group mb-0">
<span id="form-info-confidential" class="col-md-12 radio-text text-center text-md-left"
style="background-color:#cc0000;color:white;font-weight:bold;margin:5px;padding:5px;text-align: center!important; -moz-border-radius:5px 5px 5px 5px; border-radius:5px 5px 5px 5px;">Your Information is 100% Confidential</span>
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<fieldset class="pb-3 pb-md-0" id="div_brand_name">
<div class="row form-group mb-0">
<span class="col-sm-12 col-md-7 radio-text text-center text-md-left">
<div>Were you or a loved one exposed to any of these herbicides containing Paraquat?</div>
</span>
<span class=" col-sm-12 col-md-5">
<div class="form__radio-group d-inline">
<select name="brand_name" id="brand_name" vtype="not_empty" vclass="not_show" class=" form-control-lg" style="width:135px!important; height:32px; padding-top:8px !important; display: inline; color: #999; font-size: 8pt !important;"
required="">
<option value="" selected="">[ Select ]</option>
<option value="paraquat_gramoxone">PARAQUAT(GRAMOXONE®)</option>
<option value="firestorm">FIRESTORM®</option>
<option value="helmquat">HELMQUAT®</option>
<option value="parazone">PARAZONE®</option>
<option value="blanco">BLANCO®</option>
<option value="cyclone_sl">CYCLONE SL®</option>
<option value="bonedry">BONEDRY®</option>
<option value="paraquat_concentrate">PARAQUAT CONCENTRATE®</option>
<option value="devour">DEVOUR®</option>
<option value="para_shot">PARA-SHOT®</option>
<option value="willowood_paraquat">WILLOWOOD PARAQUAT®</option>
<option value="other">OTHER</option>
</select>
</div>
</span>
</div>
</fieldset>
<hr class="mt-2 mb-1" style="border-bottom: 1px solid white;">
<fieldset class="pb-3 pb-md-0" id="div_was_diagnosed">
<div class="row form-group mb-0">
<span class="col-sm-12 col-md-7 radio-text text-center text-md-left">Were you or a loved one diagnosed with Parkinson's disease after being exposed to Paraquat?</span>
<span class=" col-sm-12 col-md-5">
<div class="form__radio-group d-inline">
<input type="radio" class="form__radio-input" id="was_diagnosed_yes" name="was_diagnosed" value="1">
<label for="was_diagnosed_yes" class="form__radio-label">
<span class="form__radio-button">Yes</span>
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</div>
<div class="form__radio-group ">
<input type="radio" class="form__radio-input" id="was_diagnosed_no" name="was_diagnosed" value="0">
<label for="was_diagnosed_no" class="form__radio-label">
<span class="form__radio-button">No</span>
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</div>
</span>
</div>
</fieldset>
<hr id="hr_have_symptoms" class="mt-2 mb-1" style="border-bottom: 1px solid white; display:none;">
<fieldset class="pb-3 pb-md-0" id="div_have_symptoms" style="display:none;">
<div class="row form-group mb-0">
<span class="col-sm-12 col-md-7 radio-text text-center text-md-left">Do you or a loved one have symptoms of Parkinson's disease such as tremors or shaking?</span>
<span class=" col-sm-12 col-md-5">
<div class="form__radio-group d-inline">
<input type="radio" class="form__radio-input" id="have_symptoms_yes" name="have_symptoms" value="1">
<label for="have_symptoms_yes" class="form__radio-label">
<span class="form__radio-button">Yes</span>
</label>
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<div class="form__radio-group ">
<input type="radio" class="form__radio-input" id="have_symptoms_no" name="have_symptoms" value="0">
<label for="have_symptoms_no" class="form__radio-label">
<span class="form__radio-button">No</span>
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</span>
</div>
</fieldset>
<hr id="hr_on_dialysis" class="mt-2 mb-1" style="border-bottom: 1px solid white; display:none;">
<fieldset class="pb-3 pb-md-0" id="div_on_dialysis" style="display:none;">
<div class="row form-group mb-0">
<span class="col-sm-12 col-md-7 radio-text text-center text-md-left">Have you or a loved one been on dialysis from renal/kidney failure but are not diabetic?</span>
<span class=" col-sm-12 col-md-5">
<div class="form__radio-group d-inline">
<input type="radio" class="form__radio-input" id="on_dialysis_yes" name="on_dialysis" value="1">
<label for="on_dialysis_yes" class="form__radio-label">
<span class="form__radio-button">Yes</span>
</label>
</div>
<div class="form__radio-group ">
<input type="radio" class="form__radio-input" id="on_dialysis_no" name="on_dialysis" value="0">
<label for="on_dialysis_no" class="form__radio-label">
<span class="form__radio-button">No</span>
</label>
</div>
</span>
</div>
</fieldset>
<hr class="mt-2 mb-1" style="border-bottom: 1px solid white;">
<fieldset class="pb-3 pb-md-0" id="div_have_license">
<div class="row form-group mb-0">
<span class="col-sm-12 col-md-7 radio-text text-center text-md-left">Did the affected person have any sort of license issued by the government to apply the herbicide?</span>
<span class=" col-sm-12 col-md-5">
<div class="form__radio-group d-inline">
<input type="radio" class="form__radio-input" id="have_license_yes" name="have_license" value="1">
<label for="have_license_yes" class="form__radio-label">
<span class="form__radio-button">Yes</span>
</label>
</div>
<div class="form__radio-group ">
<input type="radio" class="form__radio-input" id="have_license_no" name="have_license" value="0">
<label for="have_license_no" class="form__radio-label">
<span class="form__radio-button">No</span>
</label>
</div>
</span>
</div>
</fieldset>
<hr class="mt-2 mb-1" style="border-bottom: 1px solid white;">
<fieldset class="pb-3 pb-md-0" id="div_have_attorney">
<div class="row form-group mb-0">
<span class="col-sm-12 col-md-7 radio-text text-center text-md-left">Do you currently have a lawyer<span class="radio-text-br"><br></span> representing your claim?</span>
<span class=" col-sm-12 col-md-5">
<div class="form__radio-group d-inline">
<input type="radio" class="form__radio-input" id="have_attorney_yes" name="have_attorney" value="1">
<label for="have_attorney_yes" class="form__radio-label">
<span class="form__radio-button">Yes</span>
</label>
</div>
<div class="form__radio-group ">
<input type="radio" class="form__radio-input" id="have_attorney_no" name="have_attorney" value="0">
<label for="have_attorney_no" class="form__radio-label">
<span class="form__radio-button">No</span>
</label>
</div>
</span>
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<input class="btn btn-lg w-100 pt-3 pb-3 mt-3 myButton " style=" color:#fff; font-size: 20px !important; font-weight: bold; text-transform: uppercase; border-radius: none !important; cursor: pointer;" type="submit" name="submit"
id="submit_claim" value="Submit My Claim">
<span style="font-size:11px; color:#888; line-height:13px; display:block; margin: 12px auto; text-align: left; width: 90%; text-align:justify;">
<label>
<input type="hidden" id="leadid_tcpa_disclosure">
<div class="form-terms"> By clicking the <span style="white-space:nowrap;">“Submit My Claim”</span> button, you certify that you have provided your legal name and your own phone number, you agree to the
<a href="/terms.php" onclick="open(this.getAttribute('href'),'CT','resizable=no,scrollbars=yes,toolbar=no,location=no,directories=no,status=no,menubar=no,width=620,height=400'); return false;" title="Terms and Conditions">Terms and Conditions</a>
and
<a href="/privacypolicy.php" onclick="open(this.getAttribute('href'),'CT','resizable=no,scrollbars=yes,toolbar=no,location=no,directories=no,status=no,menubar=no,width=620,height=400'); return false;" title="Privacy Policy">Privacy Policy</a>
and authorize Lawsuit-Winning and its <a onclick="open('/partners','CT','resizable=no,scrollbars=yes,toolbar=no,location=no,directories=no,status=no,menubar=no,width=620,height=400'); return false;" href="/partners">partners</a> to contact
you by email or at the phone number you entered using automated technology including recurring auto-dialers, pre-recorded messages, and text messages, even if your phone is a mobile number or is currently listed on any state, federal, or
corporate “Do Not Call” list. You understand that your telephone company may impose charges on you for these contacts, and that you can revoke this consent at any time. For SMS campaigns Text STOP to cancel and HELP for help. Message and data
rates may apply. By clicking the <span style="white-space:nowrap;">“Submit My Claim”</span> button and submitting this form, I affirm that I have read and agree to this Site’s
<a href="/terms.php" onclick="open(this.getAttribute('href'),'CT','resizable=no,scrollbars=yes,toolbar=no,location=no,directories=no,status=no,menubar=no,width=620,height=400'); return false;" title="Terms and Conditions">Terms and Conditions</a>
(including the arbitration provision and the E-SIGN consent) and
<a href="/privacypolicy.php" onclick="open(this.getAttribute('href'),'CT','resizable=no,scrollbars=yes,toolbar=no,location=no,directories=no,status=no,menubar=no,width=620,height=400'); return false;" title="Privacy Policy">Privacy Policy</a>.
</div>
</label>
</span>
<input id="leadid_token" name="universal_leadid" type="hidden" value="">
<input type="hidden" id="edit_lead_instance_id" name="edit_lead_instance_id" value="130234202">
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<input type="hidden" id="edit_crid" name="edit_crid" value="240723301">
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<input type="hidden" id="edit_sid3" name="edit_sid3" value="2_311604_2498650">
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<input type="hidden" id="edit_redirect_instance_id" name="edit_redirect_instance_id" value="">
<input type="hidden" id="edit_campaign_id" name="edit_campaign_id" value="311">
<input id="edit_source_url" name="edit_source_url" type="hidden" value="https://lawsuit-winning.com/paraquat3/">
<input type="hidden" id="lead_is_unique" name="lead_is_unique" value="1">
<input type="hidden" id="v" name="v" value="">
</form>
Text Content
Accessibility ✗ - Close Add Keyboard Tabbing Turn off Animations color contrast Gray Display Increase Contrast Reverse Contrast size of text Increase Text Size Decrease Text Size Remove Font highlighting content Underline Links Underline Titles Images Titles zoom in Large Cursor Large Cursor Zoom Screen Terms Report an Issue Reset Settings PARAQUAT LAWSUITS ARE NOW BEING FILED DANGEROUS WEED KILLER LINKED TO PARKINSON'S DISEASE PARKINSON'S DISEASE SIGNS & SYMPTOMS -------------------------------------------------------------------------------- * TREMOR OR SHAKING * SLOWED MOVEMENT (BRADYKINESIA) * RIGID OR STIFF MUSCLES * IMPAIRED POSTURE AND BALANCE * LOSS OF AUTOMATIC MOVEMENTS * SPEECH CHANGES * WRITING DIFFICULTY * AND MORE... PARAQUAT LAWSUITS ARE NOW BEING FILED Dangerous Weed Killer Linked to Parkinson's Disease FILL OUT THE FORM BELOW TO GET YOUR FREE CLAIM REVIEW YOU MAY BE ENTITLED TO FINANCIAL COMPENSATION! You may be entitled to financial compensation! -------------------------------------------------------------------------------- Your Information is 100% Confidential Were you or a loved one exposed to any of these herbicides containing Paraquat? [ Select ] PARAQUAT(GRAMOXONE®)FIRESTORM®HELMQUAT®PARAZONE®BLANCO®CYCLONE SL®BONEDRY®PARAQUAT CONCENTRATE®DEVOUR®PARA-SHOT®WILLOWOOD PARAQUAT®OTHER -------------------------------------------------------------------------------- Were you or a loved one diagnosed with Parkinson's disease after being exposed to Paraquat? Yes No -------------------------------------------------------------------------------- Do you or a loved one have symptoms of Parkinson's disease such as tremors or shaking? Yes No -------------------------------------------------------------------------------- Have you or a loved one been on dialysis from renal/kidney failure but are not diabetic? Yes No -------------------------------------------------------------------------------- Did the affected person have any sort of license issued by the government to apply the herbicide? Yes No -------------------------------------------------------------------------------- Do you currently have a lawyer representing your claim? Yes No By clicking the “Submit My Claim” button, you certify that you have provided your legal name and your own phone number, you agree to the Terms and Conditions and Privacy Policy and authorize Lawsuit-Winning and its partners to contact you by email or at the phone number you entered using automated technology including recurring auto-dialers, pre-recorded messages, and text messages, even if your phone is a mobile number or is currently listed on any state, federal, or corporate “Do Not Call” list. You understand that your telephone company may impose charges on you for these contacts, and that you can revoke this consent at any time. For SMS campaigns Text STOP to cancel and HELP for help. Message and data rates may apply. By clicking the “Submit My Claim” button and submitting this form, I affirm that I have read and agree to this Site’s Terms and Conditions (including the arbitration provision and the E-SIGN consent) and Privacy Policy. FIND YOURSELF A LAWYER THAT WILL FIGHT FOR YOU AND YOUR RIGHTS! Receive the Compensation You Deserve! FREE No Obligation Consultation - Pay Nothing! Your Contact Information and Your Claim are Confidential! Get Help Now! You may claim millions of dollars for your pain and suffering. You probably didn't know you could be owed money for your situation, and it is time to speak up! DON'T LET YOU OR YOUR FAMILY SUFFER in silence. If you have taken any of these, had any of these surgeries, submit your information for a FREE CLAIM REVIEW » ABOUT PARAQUAT -------------------------------------------------------------------------------- Paraquat is a herbicide used in weed killers that has been commercially available since 1962. It is one of the most widely used herbicides in the world and it's utilized to control weeds. In 2009, research published in the American Journal of Epidemiology revealed that any exposure to Paraquat within 1,600 feet of a home resulted in a heightened Parkinson's disease risk of 75 percent. If you or a loved one has Parkinson's disease and has ever worked in agriculture, been a farm worker, or lived in a rural area near farms, vineyards or orchards, you may be entitled to compensation. -------------------------------------------------------------------------------- SIGNS & SYMPTOMS -------------------------------------------------------------------------------- Parkinson's disease is a nervous system disorder that affects movement. Symptoms start gradually, sometimes starting with a barely noticeable tremor in just one hand and stiffness or the slowness of movement. Symptoms typically worsen as your condition progresses and can affect speech and expression. While Parkinson's disease can't be cured, medications might significantly improve your symptoms. TAKE ACTION -------------------------------------------------------------------------------- On October 6, 2017, a lawsuit was filed against Syngenta and Growmark, the manufacturers of Paraquat. The complaint was filed on behalf of farmers and agricultural workers who had developed Parkinson's disease after being exposed to Paraquat. Since the filing of the original claim, Chevron Chemical has been added as a defendant in the lawsuit. If you or a loved one have been diagnosed with Parkinson's disease after using Paraquat, you need to speak up! You might be eligible for financial compensation for your pain and suffering. Don't suffer in silence. Fill out a no-cost claim review to see if you are eligible to receive compensation. – complete the free and easy claim review form today. Get Help Now! IN THE NEWS -------------------------------------------------------------------------------- Pubmed.gov - April 15, 2009 *MayoClinic.org Copyright © 2021, Lawsuit-Winning Privacy Policy | Terms & Conditions | CA Residents Only - Do Not Sell My Info | California Privacy | Partners | Unsubscribe Lawsuit-Winning is devoted to helping consumers who may have been injured by prescription medications, financial fraud, automobile recalls, and various other issues where they could seek legal representation. THIS IS AN ADVERTISEMENT. This is not a law firm or referral service and does not provide legal advice. This is a free connection service only and there is no charge to be connected with an attorney. Claim reviews will be performed by a third party attorney and the attorney who receives your information may not offer a free claim evaluation. This is not a substitute for medical advice from your doctor, so never start or stop taking medication without consulting a doctor first. We do not recommend or endorse any attorneys that pay to participate in this advertisement. An attorney-client relationship is not formed when you submit the form and you are under no obligation to retain a lawyer who contacts you through this service. Services are not available in all states. This website is not affiliated in any way with any pharmaceutical company, drug producer, or attorney, and makes no claim to any registered trademarks or brands of any company. We help you find information to fight for your rights! Lawsuit Winning and this website are not affiliated in any way with Gramoxone®, Firestorm®, Helmquat®, Parazone®, Blanco®, Cyclone®, Bonedry®, Paraquat Concentrate®, Devour®, Para-Shot®, and Willowood Paraquat®. Gramoxone® is a trademark of Syngenta Group Company. Firestorm® is a trademark of Firestorm Solutions, LLC. Helmquat® is a trademark of Helm Agro US, Inc. Parazone® is a trademark of AMVAC Chemical Corporation. Blanco® is a trademark of Altitude Crop Innovations. Cyclone® is a trademark of Syngenta Crop Protection, LLC. Bonedry® is a trademark of Sinon USA, Inc. Paraquat Concentrate® is a trademark of Solera Source Dynamics, LLC. Devour® is a trademark of Innvictis Crop Care, LLC. Para-Shot® is a trademark of Sharda USA LLC. Willowood Paraquat® is a trademark of Willowood USA.