What type of birth defect occurred as a result of exposure?
Choose birth defect type Cleft Lip/Cleft Palate Early Childhood Leukemia Missing and Deformed Limbs Underdeveloped or Missing Organs Other Brain and Spinal Abnormalities Neural Tube Defects (NTDs) Retinoblastoma Other In order to be more prepared to speak with you, please briefly describe your situation below: Brief description of your situation.. * I understand and agree that submitting this form does not create an attorney-client relationship and that the information I submit is not confidential or privileged and may be shared. * I understand and agree to the Terms of Use & Privacy Policy.