Nationwide Topamax® Lawsuit

Houston
3200 Travis : 3rd Floor
Houston, TX 77006
(713) 529-0025
(713) 751-0412 (fax)

Galveston
(409) 762-9090

Toll Free
888-529-4688

andrewsteinberg@lawyer.com
www.thesteinberglawfirm.com

A Baby.

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Fill out the form below if you need additional information or want to discuss a potential claim with an attorney. All inquiries are kept strictly confidential.

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Contact Information
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Case Information

Name of Topamax® User

Date of birth of Topamax® patient (mm/dd/yyyy)

When did you start taking Topamax®?

Before Pregnancy
During 1st Trimester (Months 1-3)
During 2nd Trimester (Months 4-6)
During 3rd Trimester (Months 7-9)
After Pregnancy

Name of child with birth defect

Were you taking Topamax® during the first 3 months of pregnancy?

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When was your baby born?

What congenital or birth injuries did your baby have?

Cleft Lip
Cleft Palate
Genital Malformations
Other