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Doctor errors occur more often than people may think. Doctor errors cause about 180,000 deaths each year. People rightfully expect that they will not receive proper treatment from doctors. Doctor errors may create additional medical conditions causing medical bills to pile up, lost wages and benefits, and pain and suffering. Doctors are not infallible; they do make mistakes, do forget, and don't know everything. The myth of infallibility is probably what prevents doctor errors from being reported; people are slow to come to the conclusion that perhaps their doctor didn’t know exactly what he was doing. Waiting to file medical malpractice claims may prevent you from collecting compensation because to statute of limitation laws.

If you or someone you know has been injured due to a doctor error, you may be entitled to monetary compensation. Please fill out the form below for a free evaluation of your claim by an experienced attorney. There is no cost or obligation for this service.

Free Doctor Errors Consultation

Title:
First Name:	*
Middle Name:
Last Name:	*
Home Phone:	*
Cell Phone:
Work Phone:
Email Address:
Address:	*
City:	*
State, Zip:	* *
What is the best way to reach you? Please provide the best place, time and method for contacting you.

Injured Person Information:

Date of Birth / Age: (ex. mm/dd/yyyy or 54)
Were you injured?	Yes No
If not, who are you inquiring on behalf of?

If you are NOT inquiring on your own behalf,
what is your relationship to the injured person?

Is the person deceased?

Yes No

If deceased, what is the cause of death
as stated on the death certificate:

Date of Death: (ex. mm/dd/yyyy)
Was an autopsy performed?	Yes No
If not deceased, does the injury prevent you or the victim from working?	Yes No

If yes, when did you/victim stop working?
What is the approximate lost wages due to the injury?

Accident / Injury Information:

Name of Doctor:
Date of malpractice:	*
City where malpractice occured:	*
State where malpractice occured:	*

What type of procedure, surgery or treatment was performed?
Why do you believe malpractice occurred?
Describe injury resulting from malpractice:
Name and address of Doctor, Hospital, Nursing Home or Healthcare facility:

Case Description*
Please explain exactly what happened, trying to state
as thoroughly as possible who you believe was responsible
and why you believe that person was negligent:

Please explain the full extent of the victims injuries:

Comments / Additional Information
Is there anything else that would assist us in
understanding the facts of your case?

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Please tell us exactly what terms you typed into the
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I understand that by filling out this free consultation form I am not forming an attorney client relationship. I understand that I may only retain an attorney by entering into a fee agreement and that by submitting this form I am not entering into a fee agreement. I understand that not all submissions may receive a response.
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I agree that the above does not constitute a request for legal advice. I agree that any information that I will receive in response to the above question is general information and I will not be charged for the response to this e-mail question. I further understand that the law for each state may vary, and therefore, I will not rely upon this information as legal advice. I agree that if this matter requires advice regarding my home state, local counsel may be contacted for referral of this matter. I understand that email is not secure and thus I am not forming a confidential relationship.
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