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Request for Information About Making a RhoGAM® Claim

Information and directions for the Brayton Purcell Utah office.Information and directions for the Brayton Purcell Oregon/Washington office.Information and directions for the Brayton Purcell Southern California office.Information and directions for the Brayton Purcell Northern California office.

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RhoGAM® Case Review Form

Thank you for your interest in Brayton Purcell. Please fill out this form to receive information and a free case evaluation if you received RhoGAM® injections during pregnancy and your child was born with nervous system problems. Responding to the form questions will only take a few minutes of your time.

The fields marked below with an asterisk (*) are required.


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  1. Did you receive RhoGAM® injections during a pregnancy?*

  1. Did you receive flu shots during a pregnancy?

  1. Please provide names and birth dates of children.*
  1. Have any of your children been diagnosed with any of the listed diseases? Select all that apply:








  1. Please add any comments about your children’s injuries.

Our Beliefs

Our basic philosophy is simple—to provide our clients with excellent representation and service....more

Side Effects of Thimerosal–Containing RhoGAM® on Newborn Babies: