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If you believe that you or a loved one has been adversely affected by Vioxx, please fill out the form below. Provide as much information as possible to speed the processing of your inquiry. There is no charge for this evaluation.

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When did you take Vioxx?
Have you already been diagnosed cardiovascular disease, heart attacks, or strokes?       Yes No
Have you had any other symptoms you can attribute to taking Vioxx?       Yes No
What, if any, treatment have you had?

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