BP MEDICAL EVALUATION / BENEFITS REQUEST FORM
An Easy Form to Find Out If You Qualify For Compensation
Were you or a loved one a victim of the BP oil spill cleanup effort?
Were you an oil spill clean up worker or Gulf Coast resident?
Clean up worker
Gulf Coast resident
Where were you living during the clean up after the BP spill?
Which of the following conditions have you experienced or are you currently experiencing after being exposed to the oil or cleanup chemicals from the spill?
Have you been to a doctor or were you hospitalized?
Do you currently have an attorney handling a BP claim?
Any other information to help us better assist you
Do Not Fill This Out