EXPERT PROCUREMENT SHEET

Requested by:___________________________________


[   ] Defense       [   ] Plaintiff


Approved Alternate Office Contact Person:_________________________________

Search Urgency:    [   ] Rush      [   ] 10 Business Days      [   ] Up to 30 Days


Type of Expert(s) Requested:_____________________________________

Search Criteria:

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Case Summary:

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Conflict Screen:

___ Hospital
___ Hospital network
___ Patient/community
___ Medical school

___ Physician peer circle
___ Prior testimony
___ Conflicting lectures/articles


Other Issues:

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