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All of the asbestos trusts have very similar lists of medical conditions for which the trust will provide compensation. These conditions are asbestos-related diseases, including mesothelioma, lung cancer, a few rare other cancers, and breathing problems caused by damage to the lungs.

Have you been diagnosed with:

Mesothelioma or Lung Cancer?

If yes, the approximate date of diagnosis:

Colo-rectal, laryngeal, esophageal, pharyngeal, or stomach cancer?

If yes, the approximate date of diagnosis:

Asbestosis or severe asbestosis?

If yes, the approximate date of diagnosis:

Scarring on both of your lungs?

If yes, the approximate date of diagnosis:

Has any of your doctors told you that your medical condition is due to asbestos?

If Yes, when did your doctor tell you this?

If Yes, tell us in your own words what your doctor said about asbestos.

If you served in the military, please provide the following information:

Please provide the following information about any civilian employment that you believe may have involved exposure to asbestos.

Additional Information

Please use the box below to tell us, in your own words, any additional information about your medical condition(s) or exposure to asbestos that you would like us to know.

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Medical Information

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Additional Information