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Has a doctor said that you, a family member, or some other person you know has an asbestos disease, or that an asbestos disease was a contributing factor in his or her death?
Is this case for you or someone else, and if it is for someone else, what is his or her relationship to you?
If yes, please indicate which asbestos disease(s) the doctor diagnosed:
Please describe any asbestos exposure you may have had.