Registering Specialist Details

Solicitor Name *

Solicitor Firm Name

Contact Phone Number *

Contact E-mail *

Patient/Client Information

Gender

Age

Town/ Area/ Postcode

GP & Hospital records available?

Report Enquires

Purpose of report?

Client availablity restrictions?

Client travel restrictions?

Client requiring disabled access?

Yes  No

Court hearing date identified?

Cost limits?

Completed report format?
(word doc/ pdf/ paper)

Additional Comments

Terms and conditions

(view the Terms & conditions on a seperate page)

Terms & Conditions – Instructing Solicitors We confirm that we will be pleased to provide medical reports and related services for medical legal purposes as required by your firm from time to time on the following basis :- 1. Your instructions will require to be addressed to us electronically and/or in writing. In the event that there is special urgency, we will accept verbal instructions however you will require to provide electronic and/or written confirmation, within forty-eight hours of the verbal instructions being accepted. 2. We will exercise our reasonable professional judgement in identifying the services of appropriately qualified and experienced professionals who can offer to provide the report, or other instructed work. Once you have decided which of the appropriately qualified and experienced professionals that you would wish to proceed, we will undertake all reasonable endeavours to have them execute the work in question. In the event that we are unable to do so for whatever reason, we will advise you of the position as soon as reasonably practicable. In that event, you will have the option of withdrawing the instructions or advising us to obtain the services of a suitable substitute. 3. Our charges in respect of the provision of the services will be made clear to you when we advise you of the available services of the appropriately qualified and experienced professionals to provide the report, or other instructed work. These charges will apply from the date that we dispatch the completed report to you. 4. The fees relating to any particular instruction will become due and payable 30 days from the date that we dispatch the completed report to you. In the event that payment is not made in this period, interest will accrue thereon from the due date until payment at the rate of eight per centum per annum. 5. While we undertake to take all reasonable endeavours to ensure that all reports or other services provided will be competently executed, the expert who is responsible for the preparation of the report or provision of the service in question will be legally liable for any error, act or omission in respect thereof. We thank you for you interest in our services, and we look forward to working to our mutual benefit in the future.

I agree [until you agree to the terms you are unable to submit the form]