Daily Harvest French Lentil + Leek Crumbles Outbreak Class Action Lawsuit - Questionnaire

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Daily Harvest French Lentil + Leek Crumbles Outbreak Class Action Lawsuit - Questionnaire

This questionnaire is designed to assist us in evaluating your potential claim. Please complete a separate questionnaire for each injured person in your household.

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* Indicates required question

Email *

Your email

Phone Number *

Your answer

First Name

Your answer

Last Name

Your answer

Address

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City

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State

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ZIP

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Country

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Birthdate

MM

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DD

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YYYY

If the injured person is presently less than 18 years, please state:

Parent(s)/Guardian(s) Name:

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Address (if different from above)

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