Civil Case Request

Attorney Information
All areas marked with an astreisk (*) are required in order to submit a case.
Name*
First Last
Email*
Phone*
Cell Direct Line
Firm Name*
Address*
City State
General Case Information
Expert Level
- Consult/Merit Screen
- Consulting w/possible Testimony - Nurse
- Consulting w/possible Testimony - Doctor
Notice About Expert Levels*
"Consulting Only" - these are nurses who do not testify. Rate is between $153-210/hr
"Consulting w/possible testimony - nurse" - the nurse who reviews your case will be able to testify if needed. Rate is between $198-220/hr.
**If you discussed having a nurse review first, please choose either Consulting Only (for any nurse) or Consulting w/testimony (for a testifying nurse).
- Ok, thanks
Anticipated Testimony Date
Date Format: MM slash DD slash YYYY
Statute of Limitations Expiration Date
Date Format: MM slash DD slash YYYY
Verbal Report Needed By*
Rush fees may apply, please see our fee schedule for details
Date Format: MM slash DD slash YYYY
Verbal Report Needed Date is*
Written Report Needed By
Rush fees may apply, please see our fee schedule for details
Date Format: MM slash DD slash YYYY
Case Information
Case Type*
PLEASE SELECT ONE, regardless of your answers below.
Representation*
Case Name*
Defendant Name*
First Last
Plaintiff Name*
First Last
Additional Details
Short Description of the Case*
We prefer that you summarize the case here even if we've spoken on the phone, but you can always write "please contact me" as an option.
Other Thoughts, Concerns or Questions
Check here to acknowledge statement below*
- Acknowledged
All reports generated are delivered by email. All efforts will be made by Godoy Medical Forensics staff to ensure delivery of the report in a timely manner. We recommend that you contact us if your report is not received by the due date you specify above. By checking here, you acknowledge the risks of not receiving the report and agree to pay in full as long as reasonable efforts have been made to ensure delivery.
How did you hear about us?*
Which Conference? (optional)
Who referred you? (optional)
Upload Files & Submit Case
Please upload discovery/records for review here. If the file upload takes too long, submit the form without attachments. This is a secure site and only staff of Godoy Medical Forensics has access to the files. The submit button below works, even though the color does not change.

Two things will happen when you submit this form:
- 1) You will immediately get an email confirmation.
Do NOT navigate away until at least one of these things happen or we will not receive the form.

Save and Continue Later

This iframe contains the logic required to handle Ajax powered Gravity Forms.

Civil Case Request

Civil Case Request

Attorney Information

General Case Information

Case Information

Additional Details