Expert Witness Application Form

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

About You:

*Please note that ALL fields must be accurately completed and are essential for your application to be considered

I agree to the conditions of acceptance outlined above*.
No application will be considered without this agreement box being checked.

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*  
Re-type e-mail*  
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
   

References:

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 Referee One*
Name Two*

Email of Referee Two* (essential)
Address of Name Two*
   
Security code*:
Type in security code*(case sensitive)