Hernia Mesh Class Action - Murphy Battista LLP 2026

1. Click ‘Get Form’ to open the Hernia Mesh Class Action - Client Information Questionnaire in the editor.
2. Begin by filling out the 'Client Identification' section. Enter your first, middle, and last name, along with any other names or aliases you may have. Provide your current address, home phone, cell phone, email, date of birth, health care number, marital status, and spouse’s name if applicable.
3. Next, move to the 'Emergency Contact' section. Fill in the contact's name, address, phone numbers, email, and relationship to you.
4. In the 'Hernia Mesh Information' section, provide details about your mesh implant including the approximate date it was implanted and the hospital where it occurred. If you've had multiple repairs or removals, list each one with corresponding dates and surgeon information.
5. Indicate any symptoms experienced after implantation by checking all relevant boxes. Include details about when these symptoms first arose and provide physician information for diagnosis.
6. Complete the 'Employment Information' section by selecting your employment status and providing details about missed work due to mesh issues.
7. Finally, add any additional comments or significant health problems related to your hernia mesh experience in the designated area before submitting your form.

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