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Brain Injury Danger: Children

If your child has sustained a blow or jolt to the head and has any of the following symptoms of TBI, take him or her to the emergency room right away:

Has any of the danger signs for adults listed on the Brain Injury Danger: Adult Page
Won’t stop crying
Can’t be consoled
Won’t nurse or eat

You should contact your child’s doctor if your child vomits more than once or twice. Remember, it is better to be safe than sorry.

Brain Injury Attorney

Free Brain Injury Danger Children Consultation

Title:
First Name:	*
Middle Name:
Last Name:	*
Home Phone:	*
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Work Phone:
Email Address:
Address:	*
City:	*
State, Zip:	* *
What is the best way to reach you? Please provide the best place, time and method for contacting you.

Injured Person Information:

Date of Birth / Age: (ex. mm/dd/yyyy or 54)
Were you injured?	Yes No
If not, who are you inquiring on behalf of?

If you are NOT inquiring on your own behalf,
what is your relationship to the injured person?

Is the person deceased?

Yes No

If deceased, what is the cause of death
as stated on the death certificate:

Date of Death: (ex. mm/dd/yyyy)
Was an autopsy performed?	Yes No
If not deceased, does the injury prevent you or the victim from working?	Yes No

If yes, when did you/victim stop working?
What is the approximate lost wages due to the injury?

Accident / Injury Information:

Date of Injury:	*
City where injury occured:	*
State where injury occured:	*

Please briefly explain the incident that caused the brain/head injury:
Who do you believe was at fault in causing the injury, and what do you believe they did wrong?
Describe the injuries in detail:

Do you believe the injuries are permanent?

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Case Description*
Please explain exactly what happened, trying to state
as thoroughly as possible who you believe was responsible
and why you believe that person was negligent:

Please explain the full extent of the victims injuries:

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