GOT SHOULDER PAIN?
Take THE SURVEY now!
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Have you had severe shoulder pain in the past three years?
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Yes
No
Have you received a vaccine in the past 3 years?
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Yes
No
Did your pain start after receiving a vaccine?
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Yes
No
How long has your shoulder pain lasted?
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less than 24 hours
greater than 24 hours
What vaccine(s) did you receive immediately prior to your pain starting? Choose all that apply:
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Seasonal influenza (e.g., Flu)
Diphtheria (e.g., DTaP)
Hepatitis A
Hepatitis B
Human papillomavirus (e.g., HPV)
COVID-19
Other
Have you been diagnosed with SIRVA (Shoulder Injury Related to Vaccine Administration)?:
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Yes
No
Did you seek medical attention for your shoulder injury?
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Yes
No
Based on your responses, it is possible that your shoulder injury may be due to a vaccine. You may be entitled to significant compensation through the Vaccine Injury Compensation Program.
Click here
to call us now or simply click Submit and your survey information will be routed to our shoulder injury team. There is NO cost for representation.
Based on your responses, it does not appear your shoulder injury was related to a vaccine you received in the past three years, which is typically a pre-requisite for filing a claim for relied in the national vaccine injury compensation program.
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First
Last
What is your email?
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What is your phone number?
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