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3M Combat Earplug Lawsuit Questionnaire

Have you served in the US Military between 2003 and 2015?

Yes

If Yes, which years?

If Yes, which branch of the Military did you serve in?

Airforce

Army

Coast Guard

Marines

Navy

Other

Did you serve in a combat zone between the years 2003 and 2015?

Yes

If Yes, please select from the following regions

Iraq

Afghanistan

Other

Did you use 3M's Dual Ended Combat Arms earplugs during military service?

Yes

Have you been diagnosed by a medical professional with hearing loss or tinnitus?

Yes

Full Name

Telephone Number

Address

Time Zone

Eastern Standard time

Central Standard Time

Mountain Standard Time

Pacific Standard Time

Alaska Standard Time

Email Address

Preferred Contact Method

Phone

Mail

What is the best time to reach you?

Morning 9 am to 12 pm

Afternoon 12 pm to 5 pm

Evening 5 m to 8 pm

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