This Information Will Help Us Provide Your Child With Life Time Benefits

How long did mom carry? Please select ---------------- -32 weeks 32–36 weeks 37–40 weeks 40+ weeks I don't know

Was mom's labor induced? Please select ---------------- Yes No I don't know

How did mom deliver? Please select ---------------- Natural Emergency C-section Planned C-section I don't know

Was mom connected to an electronic fetal monitor? Please select ---------------- Yes No I don't know

Did the doctor use forceps or was a vacuum extraction performed? Please select ---------------- Yes No I don't know

Did your baby have seizures, shakes or tremors within 48 hours after delivery? Please select ---------------- Yes No I don't know

Was your baby transferred to the Neonatal Intensive care Unit? Please select ---------------- Yes No I don't know

Was the pregnancy high risk? Please select ---------------- Yes No I don't know