Mercury Investigation Intake Form

If you think you or a loved one may have been exposed to mercury from the Ashtabula Chemicals facility, please fill out the form above. After you fill out the form, our intake team will review your information carefully. After your information is reviewed, we will reach out to you. Make sure your e-mail address, phone number, and mailing address are correct. If you have any questions about this process, feel free to call us at 256-246-2500 or e-mail us at [email protected].