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At Wisner Baum, we're always ready to take your calls! Give us a call or fill out the form below to contact one of our team members.

*Were you or a loved one administered the Gardasil vaccine?
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*Age of patient when they received the Gardasil vaccine?
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*Age of patient now?
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*State where the Gardasil vaccine was received:
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*Please list adverse symptoms that were experienced due to the Gardasil vaccine:
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*Date symptoms or adverse reactions started:
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Date of medical diagnosis, if applicable:
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*Please describe your experience:
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What date did you discover Gardasil caused these symptoms?
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*How did you discover Gardasil caused these symptoms?
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*Was your case filed in Vaccine Court?
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If yes, please provide details:
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How did you find us?
*First Name
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*Last Name
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*Email
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*Primary Phone
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*City
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*State
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*Are you a new client?
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