Rochon Genova | Toronto Class Action Law Firm | Current Class Actions | Royal Canin

Royal Canin Class Action Questionnaire

Please provide the following information. Please note: This is for information gathering purposes only. This is not a claim form for compensation.

Rochon Genova will protect your name and all confidential information you submit against disclosure, publication or unauthorized user to the full extent under the law.

There is no charge or obligation for our review of your situation.

Once we have received your completed form, someone from our office will contact you with further information in the coming weeks.

What type of pet do you have?

Pet's name and Gender:

Pet's Age:

Name and Address of Veterinarian:

Your pet is:

Are the clinical notes and records available?

Brands of Pet food consumed over the past 3 years:

Please list the names of all of the stores where you purchased pet food:

Description of Pet's symptoms:

Diagnosis:

Prognosis:

Summary of Expenses for treatment, medications, blood tests, autopsy, etc. (please list each item and the associated expense):

Do you have any unopened cans or pouches of pet food

Would you be willing to send us your unopened effected cans or pouches of pet food?

Any other facts you'd like us to know:

Tell us how to get in touch with you:

Name
E-mail
Adress 1
Address 2
City and Province
Postal Code
Tel
FAX

Please contact me as soon as possible regarding this matter.