Intake form

Name *

Email address *

What is the nature of the legal case?

What is the age of the patient involved in the case?

What is the date of the incident?

What type of cardiovascular condition is involved?

Please select at least one option.

Coronary Artery Disease

Heart Failure

Arrhythmia

Valvular Heart Disease

Hypertension

What documents do you have related to the case?

Please select at least one option.

Medical Records

Billing Statements

Expert Testimony

Witness Statements

Please describe the main issues or concerns regarding the case.

Which service or services are you interested in?

Please select at least one option.

Expert Cardiology case review

Comprehensive medical record analysis

Customized expert testimony preparation

Additional questions or comments