Do you have a email or can your phone receive text messages? Must Be Yes

Were you residing, stationed or worked at Camp Lejeune Or MCAS New River Between August 1, 1953 and December 31, 1987 for at least 30 total or cumulative days? Must Be Yes

Where you a marine, military or dependent of someone stationed at camp Lejeune? Must choose one

If veteran (Were you honorably discharged)? Must Be Yes 

If dependent (Do you have the Social Security Number of the person you resided with)? Must Be Yes

Will you be able to provide a copy of your birth certificate? (Must Be Yes)

Were you diagnosed with Bladder Cancer, Kidney Cancer, End Stage Renal Disease, Liver Cancer, Leukemia Cancer,  Multiple Myeloma, Non Hodgkin’s Lymphoma, Systemic Sclerosis / Systemic Scleroderma, Parkinson's Disease? (Must Choose One)

Do you have an attorney or EVER had an Attorney for this Camp Lejeune Claim(were you denied)? (Must Be No)

Accepted Nation Wide