INICIO
ÁREAS DE PRÁCTICA
ACERCA
CONTACTO
DIRECCIÓN
MÁS
HAVE YOU BEEN EXPOSED TO ASBESTOS?
Do you consider yourself to be in good health?
Yes
No
Have you been diagnosed with an asbestos-related disease?
Yes
No
If yes, please select all that apply?
Asbestosis
Pleural Thickening
Pleural Plaques
Lung Cancer
Mesothelioma
Have you ever worked for a year or more in any dusty job?
Yes
No
Have you ever worked with or around asbestos?
Yes
No
What was the timeframe of your last exposure to dust/asbestos?
1940s - 1950s
1960s - 1970s
1980s - 1990s
2000s
Have you or your loved one ever worked as: (Select all that apply)
A carpenter
A construction trade person
An electrician
A plumber and/or pipefitter
A plaster and drywall installer
An auto mechanic or plane mechanic
An insulator
A laborer
A painter
A roofer
Submit
