www.camplejeuneclaimshelp.com
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https://www.camplejeuneclaimshelp.com/?requestid=633d944f51719&s1=426727&s2=da1cjakv5_qxdcnK2Uzj19k&s3=&s4=&s5=9b3298802e5a4f2e947249e...
Submission: On October 05 via manual from IN — Scanned from DE
Submission: On October 05 via manual from IN — Scanned from DE
Form analysis
1 forms found in the DOMPOST
<form novalidate="" class="form email-form contents form-labels-outside-top" method="post" data-id="element-516" data-at="form" action-xhr="https://d.fastcdn.co/submissions">
<div class="form-checkable-field">
<label class="form-label-title form-label form-label-radio" for="field-f3d4a91268c20db09bf87f5582137b81-0" data-at="form-radio-title">Did you or a loved one serve, live, or work at Camp Lejeune for at least 30 days between 1953 and 1987?</label>
<div class="form-block-radio">
<input id="field-f3d4a91268c20db09bf87f5582137b81-0-0" class="form-multiple-input required" data-at="form-radio" type="radio" name="Did you or a loved one serve, live, or work at Camp Lejeune for at least 30 days between 1953 and 1987?"
data-describedby="form-validation-error-box-element-" value="Yes" required="" aria-required="false">
<label class="form-label form-multiple-label form-radio-label" for="field-f3d4a91268c20db09bf87f5582137b81-0-0" data-at="form-radio-label">Yes</label>
</div>
<div class="form-block-radio">
<input id="field-f3d4a91268c20db09bf87f5582137b81-0-1" class="form-multiple-input required" data-at="form-radio" type="radio" name="Did you or a loved one serve, live, or work at Camp Lejeune for at least 30 days between 1953 and 1987?"
data-describedby="form-validation-error-box-element-" value="No" required="" aria-required="false">
<label class="form-label form-multiple-label form-radio-label" for="field-f3d4a91268c20db09bf87f5582137b81-0-1" data-at="form-radio-label">No</label>
</div>
</div>
<label class="form-label-title form-label-outside form-label" for="field-f3d4a91268c20db09bf87f5582137b81-1" data-at="form-select-title">What injury were you or your loved one diagnosed with?</label>
<div class="form-block-select">
<select id="field-f3d4a91268c20db09bf87f5582137b81-1" class="form-input form-select required " data-at="form-select" name="What injury were you or your loved one diagnosed with?" data-describedby="form-validation-error-box-element-516"
title="What injury were you or your loved one diagnosed with?" required="" aria-required="true">
<option class="hidden" value="" disabled="" selected="">-- Select one--</option>
<option class="form-select-option" value="Amyotrophic Lateral Sclerosis (ALS)" data-at="form-select-option">Amyotrophic Lateral Sclerosis (ALS)</option>
<option class="form-select-option" value="Aplastic anemia" data-at="form-select-option">Aplastic anemia</option>
<option class="form-select-option" value="Autoimmune disease" data-at="form-select-option">Autoimmune disease</option>
<option class="form-select-option" value="Appendix cancer" data-at="form-select-option">Appendix cancer</option>
<option class="form-select-option" value="Bile duct cancer" data-at="form-select-option">Bile duct cancer</option>
<option class="form-select-option" value="Birth defects (non-cardiac)" data-at="form-select-option">Birth defects (non-cardiac)</option>
<option class="form-select-option" value="Bladder cancer" data-at="form-select-option">Bladder cancer</option>
<option class="form-select-option" value="Brain cancer" data-at="form-select-option">Brain cancer</option>
<option class="form-select-option" value="Breast cancer" data-at="form-select-option">Breast cancer</option>
<option class="form-select-option" value="Cardiac birth defects" data-at="form-select-option">Cardiac birth defects</option>
<option class="form-select-option" value="Cervical cancer" data-at="form-select-option">Cervical cancer</option>
<option class="form-select-option" value="Cognitive disability (birth injury)" data-at="form-select-option">Cognitive disability (birth injury)</option>
<option class="form-select-option" value="Colorectal cancer" data-at="form-select-option">Colorectal cancer</option>
<option class="form-select-option" value="Congenital malformation" data-at="form-select-option">Congenital malformation</option>
<option class="form-select-option" value="Conjoined twins" data-at="form-select-option">Conjoined twins</option>
<option class="form-select-option" value="Esophageal cancer" data-at="form-select-option">Esophageal cancer</option>
<option class="form-select-option" value="Female infertility" data-at="form-select-option">Female infertility</option>
<option class="form-select-option" value="Hepatic steatosis" data-at="form-select-option">Hepatic steatosis</option>
<option class="form-select-option" value="Hodgkin’s lymphoma" data-at="form-select-option">Hodgkin’s lymphoma</option>
<option class="form-select-option" value="Hypersensitivity skin disorder" data-at="form-select-option">Hypersensitivity skin disorder</option>
<option class="form-select-option" value="Intestinal cancer" data-at="form-select-option">Intestinal cancer</option>
<option class="form-select-option" value="Kidney cancer" data-at="form-select-option">Kidney cancer</option>
<option class="form-select-option" value="Kidney disease" data-at="form-select-option">Kidney disease</option>
<option class="form-select-option" value="Leukemia" data-at="form-select-option">Leukemia</option>
<option class="form-select-option" value="Liver cancer" data-at="form-select-option">Liver cancer</option>
<option class="form-select-option" value="Liver cirrhosis" data-at="form-select-option">Liver cirrhosis</option>
<option class="form-select-option" value="Lung cancer" data-at="form-select-option">Lung cancer</option>
<option class="form-select-option" value="MDS (Myelodysplastic syndromes)" data-at="form-select-option">MDS (Myelodysplastic syndromes)</option>
<option class="form-select-option" value="Miscarriage" data-at="form-select-option">Miscarriage</option>
<option class="form-select-option" value="Multiple myeloma" data-at="form-select-option">Multiple myeloma</option>
<option class="form-select-option" value="Multiple sclerosis" data-at="form-select-option">Multiple sclerosis</option>
<option class="form-select-option" value="Neurobehavioral effects" data-at="form-select-option">Neurobehavioral effects</option>
<option class="form-select-option" value="Non-Hodgkin's lymphoma" data-at="form-select-option">Non-Hodgkin's lymphoma</option>
<option class="form-select-option" value="Ovarian cancer" data-at="form-select-option">Ovarian cancer</option>
<option class="form-select-option" value="Pancreatic cancer" data-at="form-select-option">Pancreatic cancer</option>
<option class="form-select-option" value="Parkinson's disease" data-at="form-select-option">Parkinson's disease</option>
<option class="form-select-option" value="Renal toxicity" data-at="form-select-option">Renal toxicity</option>
<option class="form-select-option" value="Rectal cancer" data-at="form-select-option">Rectal cancer</option>
<option class="form-select-option" value="Scleroderma" data-at="form-select-option">Scleroderma</option>
<option class="form-select-option" value="Soft tissue sarcoma" data-at="form-select-option">Soft tissue sarcoma</option>
<option class="form-select-option" value="Thyroid cancer" data-at="form-select-option">Thyroid cancer</option>
<option class="form-select-option" value="Other cancer" data-at="form-select-option">Other cancer</option>
<option class="form-select-option" value="Other injury" data-at="form-select-option">Other injury</option>
<option class="form-select-option" value="No injury" data-at="form-select-option">No injury</option>
</select>
</div>
<label class="form-label-title form-label-outside form-label" for="field-f3d4a91268c20db09bf87f5582137b81-2" data-at="form-text-title">First Name</label>
<input id="field-f3d4a91268c20db09bf87f5582137b81-2" class="form-input form-input-text required " data-at="form-text" type="text" name="First Name" data-describedby="form-validation-error-box-element-516" value="" title="First Name" placeholder=""
data-label-inside="First Name" required="" aria-required="true">
<label class="form-label-title form-label-outside form-label" for="field-f3d4a91268c20db09bf87f5582137b81-3" data-at="form-text-title">Last Name</label>
<input id="field-f3d4a91268c20db09bf87f5582137b81-3" class="form-input form-input-text required " data-at="form-text" type="text" name="Last Name" data-describedby="form-validation-error-box-element-516" value="" title="Last Name" placeholder=""
data-label-inside="Last Name" required="" aria-required="true">
<label class="form-label-title form-label-outside form-label" for="field-f3d4a91268c20db09bf87f5582137b81-4" data-at="form-email-title">Email</label>
<input id="field-f3d4a91268c20db09bf87f5582137b81-4" class="form-input form-input-text required " type="email" name="Email" data-describedby="form-validation-error-box-element-516" value="" title="Email" data-label-inside="Email"
data-at="form-email" placeholder="" required="" aria-required="true">
<label class="form-label-title form-label-outside form-label" for="field-f3d4a91268c20db09bf87f5582137b81-5" data-at="form-text-title">Phone Number</label>
<input id="field-f3d4a91268c20db09bf87f5582137b81-5" class="form-input form-input-text required form-input-mask" data-at="form-text" type="text" name="Phone Number" data-describedby="form-validation-error-box-element-516" value=""
title="Phone Number" data-mask="(000) - 000-0000" pattern="[0-9]*" inputmode="numeric" placeholder="" data-label-inside="Phone Number" required="" aria-required="true">
<label class="form-label-title form-label-outside form-label" for="field-f3d4a91268c20db09bf87f5582137b81-6" data-at="form-textarea-title">Briefly describe what happened (optional)</label>
<div class="form-block-textarea">
<textarea id="field-f3d4a91268c20db09bf87f5582137b81-6" class="form-input form-textarea " data-at="form-textarea" name="Briefly describe what happened (optional)" data-describedby="form-validation-error-box-element-516"
title="Briefly describe what happened (optional)" placeholder="" data-label-inside="Briefly describe what happened (optional)" aria-required="false" maxlength="250"></textarea>
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<input type="hidden" id="field-f3d4a91268c20db09bf87f5582137b81-18" name="utm_campaign" value="[utm_campaign]" data-at="form-hidden-input">
<input type="hidden" id="field-f3d4a91268c20db09bf87f5582137b81-19" name="utm_medium" value="[utm_medium]" data-at="form-hidden-input">
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<input type="hidden" id="field-f3d4a91268c20db09bf87f5582137b81-25" name="cr" value="" data-at="form-hidden-input">
<input type="hidden" name="zapier2-integration"
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TIME IS LIMITED TO FILE! ATTENTION: FIND OUT IF YOU QUALIFY SIGNIFICANT COMPENSATION MAY BE AVAILABLE If you lived, worked, or served at Marine Corps Base Camp Lejeune, you may be entitled to SIGNIFICANT Compensation Settlement payments for Camp Lejeune veterans are estimated to be $6.7 billion but time is limited - see if you qualify TODAY Did you or a loved one serve, live, or work at Camp Lejeune for at least 30 days between 1953 and 1987? Yes No What injury were you or your loved one diagnosed with? -- Select one-- Amyotrophic Lateral Sclerosis (ALS) Aplastic anemia Autoimmune disease Appendix cancer Bile duct cancer Birth defects (non-cardiac) Bladder cancer Brain cancer Breast cancer Cardiac birth defects Cervical cancer Cognitive disability (birth injury) Colorectal cancer Congenital malformation Conjoined twins Esophageal cancer Female infertility Hepatic steatosis Hodgkin’s lymphoma Hypersensitivity skin disorder Intestinal cancer Kidney cancer Kidney disease Leukemia Liver cancer Liver cirrhosis Lung cancer MDS (Myelodysplastic syndromes) Miscarriage Multiple myeloma Multiple sclerosis Neurobehavioral effects Non-Hodgkin's lymphoma Ovarian cancer Pancreatic cancer Parkinson's disease Renal toxicity Rectal cancer Scleroderma Soft tissue sarcoma Thyroid cancer Other cancer Other injury No injury First Name Last Name Email Phone Number Briefly describe what happened (optional) Do I Qualify ➔ "The water at Camp Lejeune was a hidden hazard, and it is only years later that we know how dangerous it was." - Secretary Robert McDonald US Department of Veteran Affairs CAMP LEJEUNE KNOWINGLY SERVED HIGHLY CONTAMINATED WATER TO MARINES & THEIR FAMILIES FOR MORE THAN 3 DECADES WHAT HAPPENED AT CAMP LEJEUNE? TOXIC CHEMICALS & WASTEWATER WERE DUMPED INTO STORM DRAINS POLLUTING THE WATER SUPPLY FOR 30+ YEARS * Many servicemen and their families have developed life threatening health conditions from drinking this water. * The VA has denied claims of affected individuals for years. * A new law passed in 2022 allows affected individuals to sue and recover damages they deserve. By clicking 'Do I Qualify' and submitting my request, I confirm that I have read and agree to the privacy policy of this site and that I consent to receive emails, phone calls and/or text message offers and communications from Total Injury Help, and its network of lawyers and advocates at any telephone number or email address provided by me, including my wireless number, if provided. I understand there may be a charge by my wireless carrier for such communications. I understand these communications may be generated using an autodialer and may contain pre-recorded messages and that consent is not required to utilize Total Injury Help services. I understand that this authorization overrides any previous registrations on a federal or state Do Not Call registry. Accurate information is required for a free evaluation. IF YOU OR A LOVED ONE SERVED, WORKED, OR LIVED AT CAMP LEJEUNE BETWEEN 1953 AND 1987, OUR TEAM WILL FIGHT TO GET YOU THE HIGHEST POSSIBLE SETTLEMENT. ACT QUICKLY - TIME IS LIMITED! See if I Qualify for Compensation ➔ CAMP LEJEUNE WATER CONTAMINATION ROUTINE WATER TESTING IN 1982 FOUND THAT DRINKING WATER SOURCES AT CAMP LEJEUNE WERE CONTAMINATED WITH DANGEROUS CHEMICALS KNOWN TO BE CARCINOGENIC OR HARMFUL TO HUMANS. CONTAMINATION OF WATER WAS DOCUMENTED AT UP TO 300 TIMES ACCEPTABLE LEVELS IN SOME CASES. FOR DECADES, CAMP LEJEUNE WATER WAS CONTAMINATED BY LEAKING UNDERGROUND WATER STORAGE TANKS AND WASTE DISPOSAL SITES. THESE DANGERS WERE IGNORED AND THE WATER WAS SERVED TO MANY INNOCENT MARINES & THEIR FAMILIES THAT HAVE DEVELOPED CANCER AND OTHER SERIOUS HEALTH PROBLEMS RELATED TO THE CHEMICALS. HEALTH CONDITIONS MAY INCLUDE: > BLADDER CANCER > BREAST CANCER > CARDIAC BIRTH DEFECTS> ESOPHAGEAL CANCER > FEMALE INFERTILITY > HEPATIC STEATOSIS > KIDNEY CANCER > LEUKEMIA > LIVER CANCER> LUNG CANCER > MDS(MYELODYSPLASTIC SYNDROMES) > MISCARRIAGE> MULTIPLE MYELOMA > NEUROBEHAVIORAL EFFECTS> NON-HODGKIN’S LYMPHOMA> PARKINSON’S DISEASE> RENAL TOXICITY> SCLERODERMA> OTHER INJURY See if I Qualify for Compensation ➔ TIME IS RUNNING OUT - FILL OUT THE FORM TO SEE IF YOU QUALIFY! 1. COMPLETE THE FORM 2. FREE CASE REVIEW 3. POSSIBLE COMPENSATION A recent law passed by Congress entitles affected individuals to compensation, but time is limited. Complete the form TODAY to make sure you have the best chance to receive the justice you deserve. Our team will call you as soon as possible to discuss your options and collect information needed to get the settlement you deserve. This is completely free with no obligations. Your attorney will fight for you to receive the best possible compensation. There are no up-front costs to you. Your attorney will only get paid when a settlement is won for your case. CAMP LEJEUNE JUSTICE ACT OF 2022 IN JUNE 2022, THE US SENATE PASSED THE HONORING OUR PACT ACT WITH A BIPARTISAN VOTE OF 84-13. THIS ACT INCLUDES CRITICAL SUPPORT FOR VICTIMS OF CAMP LEJENUE WATER CONTAMINATION, AND ALLOWS IMPACTED INDIVIDUALS TO FILE A CLAIM FOR SIGNIFICANT COMPENSATION. MANY OF THESE INDIVIDUALS WHO DEVELOPED SEVERE ILLNESS DUE TO GOVERNMENT NEGLIGENCE AT CAMP LEJENUE HAVE HAD THEIR CLAIMS INAPPROPRIATELY DENIED OR DELAYED BY THE VA, RESULTING IN ADDITIONAL HARM. PEOPLE OR LOVED ONES OF THOSE WHO LIVED, WORKED, OR WERE STATIONED AT CAMP LEJEUNE WHO EXPERIENCED A WATER TOXICITY-RELATED ILLNESS MAY NOW BE ELIGIBLE FOR A SIGNIFICANT SETTLEMENT. CONTACT OUR EXPERT TEAM TODAY TO GET THE JUSTICE THAT YOU DESERVE! THERE IS NO UPFRONT COST TO USING THE ATTORNEYS AND THE CONSULTATION IS 100% FREE OF CHARGE. IN THE EVENT, THEY WIN YOUR CASE, YOUR ATTORNEYS WILL RECEIVE A CONTINGENCY FEE BASED ON THE FUNDS THEY RECOVER TO PAY FOR COSTS. YOU PAY NOTHING UNLESS YOU WIN. See if I Qualify for Compensation ➔ This is a legal advertisement Attorney Advertising Disclaimer: The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact us and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. Prior results do not guarantee a similar outcome. Privacy Policy Terms and Conditions Thank You!