Become a Medical Expert Witness Form

To Apply to Become A Medical Expert Witness, Submit Your Information Below

If you are an expert witness interested in being added to our network, please submit your information below. As cases come in, we will review the experts in our database to determine if you meet the qualifications.

Contact Information:

Name

Street Address

City

Postal Code

State/Region

Phone

Preferred Method of Contact

Profile Picture

Preferred Day/Time for Consult Calls

Expert Specialty & State License

Upload copy of C.V

Expert Specialty

Licensed States

Other Type of Specialty:

Biography for Expert Profile

Expert's Rates & Payment

Upload W-9

Upload Fee Schedule

or please explain your rates below

Expert Questionnaire

I have an active medical license.

Yes No

I am currently the defendant in a malpractice suit.

Yes No

If you're a medical professional - Are you board-certified?

Yes No