Thank you again for your interest. To better get to know you and your qualifications, please complete this questionnaire. Dr. Herman will be back in touch with you should we require additional information.

Medical Expert Witness

Questionnaire


    Some routine background questions: (please explain any 'YES' answers)
    Have you testified before? YesNo
    If yes, please explain.
    Deposition? YesNo
    If yes, please explain.
    At Trial? YesNo
    If yes, please explain.
    Have you ever had your license to practice denied, suspended, revoked, limited in any way, or placed on probation?YesNo
    If yes, please explain.
    Have you ever been denied privileges or had privileges acted on in any way?YesNo
    If yes, please explain.
    Did you pass all licensing and specialty board exams on the first attempt?YesNo
    If yes, please explain.
    Have you ever been sued for malpractice?YesNo
    If yes, please explain.
    Have you ever been convicted of a crime?YesNo
    If yes, please explain.
    Anything potentially adverse that we should know?YesNo
    If yes, please explain.

    Please include your fee schedule for your forensic work.


    Thank you for your interest and your replies.
    I will be back in touch with you.