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To locate an attorney to evaluate your case, choose from a practice area below:






Hormone Replacement Therapy
Free Case Evaluation
Texas Lawyers

Please complete the form below to contact a Hormone Replacement Therapy Lawyer in Texas. Be sure to complete all fields in full and be as descriptive as possible about your case so that we can be as thorough as possible with our free case evaluation.

First Name:

Last Name:

Street Address:

Suite:

City:

State:
Zip Code:

Home Phone:

Work Phone:

Cell Phone:

Fax:

Email:

Did you take any of the following Combination Hormone Therapy Replacement drugs? Check all that apply.

Drug   Year Started    Year Ended
Prempro®      
Premphase®      
FemHRT®      
None of the Above 

Did you take any of the following Estrogen Only Hormone Therapy Replacement drugs? Check all that apply.

Drug   Year Started    Year Ended
Premarin®      
Estradiol®      
None of the Above 

Did you take any of the following Progestin Only Hormone Therapy Replacement drugs? Check all that apply.

Drug   Year Started     Year Ended
Provera®      
Medroxyprogesterone      Acetate (MPA)      
None of the Above 

Have you ever been diagnosed with any of the following cancers:

Ductal Breast Cancer
Lobular Breast Cancer
Other Breast Cancer
Ovarian Cancer
Gall Bladder Cancer
Non Hodgkins Lymphoma
None of the Above


Please identify when the condition you selected above was diagnosed?




If you were diagnosed with breast cancer, do you know if your Hormone Receptors were positive for Estrogen and or Progesterone?




Please include any additional comments you might have. Please be sure to include:

  • Your Date of Birth and Your Occupation
  • The best time to call you. Daytime, Nightime, At Home or at Work?
  • Any other information you believe is relevant to your situation including family medical history, whether or not you are a smoker, if you have ever had a hysterectomy, etc.











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