Essure Follow-Up Qs

1. Do you have an attorney for your Essure case or have you previously settled an Essure lawsuit?
2. Did you have an Essure permanent birth control device implanted anytime after Jan 1st, 2008?
3. What date (Month/Year) was your Essure implanted?
4. Did you undergo surgical removal of the Essure device due to health complications?
5. When was your Essure device surgically removed? (Please provide Month & Year)
6. Which of the following surgical removal procedures was performed?
   1. Hysterectomy – Uterus
   2. Hysterectomy – Uterus & Cervix
   3. Bilateral Salpingectomy
   4. Unilateral Salpingectomy
   5. Bilateral Salpingo-oophorectomy  
   6. Unilateral Salpingo-oophorectomy
   7. Hysterectomy with Unilateral Salpingectomy  
   8. Hysterectomy with Bilateral Salpingectomy
   9. Hysterectomy with Unilateral Salpingo-oophorectomy
   10. Hysterectomy with Bilateral Salpingo-oophorectomy
   11. Surgical Removal of Coils

7. Please provide the name and address of medical facility where your Essure device was surgically removed.
8. Please provide the name and address of medical facility where your Essure device was originally implanted.
9. What is your date of birth?
10. What is your physical address?
11. Please provide any additional information which you feel may be important to help support your potential claim.