Expert Witness Application Form

Expert witness, medical malpractice, personal injury

Expert medical witnesses can register for our searchable database available to solicitors and lawyers worldwide.

We need accurate and complete details submitted in the form below

Conditions of Acceptance: By entering details into this searchable database you hereby agree that Green MedicoLegal Ltd. can hold these details on file indefinitely. Your entry will appear on-line after references have been checked.. Green MedicoLegal reserves the right to refuse or remove any application or details at any time. By applying here you guarantee that you are:

a the person named in the application
b currently fully qualified and allowed to practice in your own geographical region or state
c have experience in writing court reports and have previously acted as an expert medical or paramedical witness
d will respond helpfully and as positively as possible to local enquiries from solicitors, barristers or lawyers

I agree to the conditions of acceptance outlined above.

No application will be considered without this agreement box being checked.

About You:

Please note that ALL fields must be accurately completed for your application to be considered

Title      (Dr, Assistant Professor, Prof)
First Name 
Surname  
Main Qualifications e.g. M.D.  
Date of Qualification
Main Awarding Institution e.g. University of Cambridge
Other Qualifications e.g. ILTM, ChB
Country you practice in:
Medical Speciality or Profession e.g. Orthopaedics, Psychiatry, Nursing, Physiotherapy
Membership of any Societies
Which Private Hospitals do you practice at?
Phone Number
Fax Number (if available)
E-mail  
Password (for logging on to change details)  
Confirm password  
Web Page (if available)

Correspondence address for solicitors/lawyers to contact?

What is your Field of Expertise? - please list as many relevant areas as possible

Please can you list the valid names, and valid emails and addresses of two professional referees - lawyers or doctors - who will vouch for your skills as an expert witness when we ask them?

We cannot process any application without contacting your referees.

Name One

Email of Referee One (essential)

Address of Name One

Name Two

Email of Referee Two (essential)

Address of Name Two

 

 

This form is copyright Green MedicoLegal Ltd. 2001-2005