Erbs Palsy Submission

Child Diagnosed with Erb's Palsy? Speak to an Attorney
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Our attorneys handle claims related to Erb's Palsy, Shoulder Dystocia and related birth injuries throughout the country. Submit your case for a no-cost confidential discussion. Please read our disclaimer and terms of use. You may also call us national toll free at 1-800-942-2056.


First Name:

  M. I.


 Last Name:




 Zip Code:

 Phone Number (day):

 Phone Number (eve):

Email Address 

 If this inquiry is not for yourself, please tell us the name of the person?:



First Name:



Last Name:

What is the Injured's relationship to you?:

 Injured's Date of Birth:
Please use format: mm/dd/19yy)

Have you or a loved one suffered from Erbs Palsy?:

 Yes No

 Date of incident?

 City and State where incident occurred?

Please provide a brief description of what happened:
 I understand that submitting this form does not create an attorney client relationship: Agree

Submit by pressing button below