Medical Expert Witness Profiles | Expert Witness Background Information | Expert Witness Profile Report

What is your full name?*

What is your area of expertise?*

How many years of experience in this particular field do you have?*

Are you board certified? If yes, when does your certification expire?*

What is your email address?*

What is the best telephone number to reach you?*

Are you currently practicing in the field specified above?*

Yes
No

Are you a faculty member at a university?*

Yes
No

Has any board or committee ever taken action against you or to reprimand you, place you on probation, revoke, limit or otherwise affect your ability to practice?*

Yes
No

Have you been denied membership or renewal thereof in any organization or institution?*

Yes
No

Do you have malpractice insurance that is currently in effect?*

Yes
No

Have you ever had any criminal charges files against you?*

Yes
No

Have you ever had a malpractice case decided against you?*

Yes
No

Have you settled (or had settled by your insurance carrier) a malpractice case against you?*

Yes
No

Have you ever reviewed a legal case as an expert for the defense?*

Yes
No

Have you ever reviewed a legal case as an expert for the plaintiff?*

Yes
No

If you have reviewed legal cases, approximately how many would you say you have reviewed?

Of those cases, what was the split between plaintiff and defense reviews?

Of those cases, how many have you provided trial testimony?

Can you supply two references for whom you have performed legal reviews? (OPTIONAL)

Name of attorney, law firm, address, email and telephone number

Upload your current CV or resume

Max. file size: 256 MB.

Please upload in Word format. If you are unable to upload, please send your CV to us via regular mail, fax or email.

Upload your current fee schedule

Max. file size: 256 MB.

If you are unable to upload, please send your fees to us via regular mail, fax or email

Upload a current photo (OPTIONAL)

Max. file size: 256 MB.

If you are unable to upload, please send via regular mail.

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I Agree to the Expert Terms of Service Agreement*

Yes

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Expert Questionnaire