***This website will be offline for scheduled maintenance from Friday, June 30, 2017, at 9:00 PM ET until 2:00 PM ET on Saturday, July 1, 2017.***
Sign Up for Future Information on Registration Period
 
Instructions: If you would like to receive more information on how to register for the Settlement, once it is approved by the Court, fill out the form below. At a later date, you will receive complete information on how to register for benefits. The sections marked with an * must be completed.

If you are a lawyer and would like to sign up multiple clients in a group, email the Claims Administrator at ClaimsAdministrator@NFLConcussionSettlement.com for assistance.
Name: *
Country: *
Address 1: *
Address 2:
City: *
State: *
Zip/Postal Code * -
Current Phone Number: *
- -
Email Address: *
Check the appropriate box below to indicate if you are a: *
Retired NFL Player
Authorized representative of a Retired NFL Player or deceased Retired NFL Player
 
Name the Retired NFL Player you represent:
Counsel to a Retired NFL Player or to a representative of a Retired NFL Player or deceased Retired NFL Player
 
Name the Retired NFL Player you represent:
Spouse, parent, or dependent child of a Retired NFL Player or deceased Retired NFL Player
 
Name the Retired NFL Player with whom you have or had relationship:
Other
1-855-887-3485 | ClaimsAdministrator@NFLConcussionSettlement.com | P.O. Box 25369 Richmond, VA 23260