John Doe and Jane Doe, et al. v. Partners Healthcare System, Inc., et al.

Case No. 1984CV01651-BLS1

The Suffolk Superior Court in the Commonwealth of Massachusetts

If you received a personalized notice in the mail or via email with a Notice ID and Confirmation Code, please enter the codes you were provided below.

Please remember to enter the full Notice ID exactly as it appears on your personalized Notice, (i.e. 12345678).

TO FILE A CLAIM, THIS FORM MUST BE SUBMITTED BY DECEMBER 15, 2021


To print and mail a claim form, click HERE. To file your claim online, proceed to the fields below:

I. Claimant Information:

Please review the following information. If needed, you may update below.

* Required Fields
II. PAYMENT SELECTION:

Please select one of the following payment options:





*Denotes Information You Must Provide To Have A Valid Claim

I am/was a Patient of the Defendants between May 23, 2016, and July 31, 2021.

I visited the Informational Websites between May 23, 2016, and July 31, 2021.

I was a resident of Massachusetts between May 23, 2016, and July 31, 2021.

I received medical care in Massachusetts from one or more of Defendants between May 23, 2016, and July 31, 2021.


The final amount per class member will depend on the total number of valid claim forms received, but will not exceed $100.
III. Certification:

I certify and affirm that the information I am providing is true and correct to the best of my knowledge and belief, I am over the age of 18 and I wish to claim my share of the Settlement Fund. (If you are under the age of 18, please see FAQ #11)

Your Claim Form has been submitted successfully.

HOWEVER, it appears one or more of the documents you uploaded were not successfully received. Please see below for which file(s) had errors and log back in to your existing Claim online to re-upload your document(s). Alternatively, you can send your documents with your Submitted Claim ID to the Settlement Administrator by email to: Info@MACookieSettlement.com.

Please print this page for your records.

You will receive momentarily an email confirmation with the information below.

Your Claim Details

Submitted Notice ID:
Confirmation Code:
You will need the above Submitted Claim ID and Confirmation Code if you would like to edit your Claim at a later time, so please print this page for your records.
CLAIM INFORMATION
First Name
Middle Initial
Last Name
Street Address
City
State
Zip Code
Email Address
Telephone Number
Payment Method
I am/was a Patient of the Defendants
between May 23, 2016, and July 31, 2021.
I visited the Informational Websites
between May 23, 2016, and July 31, 2021.
I was a resident of Massachusetts
between May 23, 2016, and July 31, 2021.
I received medical care in Massachusetts
from one or more of Defendants between May 23, 2016, and July 31, 2021.
Signature
Date

If you have any questions regarding your Claim, please provide the Submitted Claim ID listed above and email us at Info@MACookieSettlement.com