HeartDevice.com

HEART DEVICE CLAIM FORM

If you or a loved one have received a Medtronic or Guidant heart device or suffered a serious injury or side effect after receiving a heart device, please fill out the form and a lawyer will review your information within 24 hours.

Name:
Address:
City:
State:
Zip:
Day phone:
Evening phone:
Email Address:

Have you received a Medtronic, Guidant, or other heart device?	Yes	No
Name of Heart Device/Procedure
Have you experienced side effects?	Yes	No
Have you been diagnosed?	Yes	No

Describe Injury/Problem:

HeartDevice.com is a resource for consumers and lawyers about Medtronic and Guidant recalls, heart device recalls, heart valve, heart stent, heart wire, heart lead, pacemaker, and defibrillator recalls, warnings, and lawsuits.