Cerebral Palsy Attorneys - Handling Cerebral Palsy Cases Nationwide
Cerebral Palsy and Brain Injuries in Children can be due to Complications at Birth
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1
Contact info
2
Birth conditions
3
Hospitalization
Please fill out each question:
Your name:
Email:
Phone number:
Does your child have cerebral palsy or brain damage?
Yes
No
How many weeks pregnant were you at time of delivery?
Baby's birth weight?
How did mom deliver?
Vaginal
Forceps/Vacuum
C/S
Was the baby's heart rate dropping prior to birth?
Yes
No
Was the baby breathing after birth?
Yes
No
Apgar scores, if known:
Did your baby require a breathing tube?
Yes
No
Did your baby have an MRI, Ultrasound, or CT of the brain?
Yes
No
What were the results?
Normal
Abnormal
How long did your baby remain in the hospital?
If you baby went home on medications, which ones?
Anything to add?
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