Medicolegal Booking Request for Law Firms

1. Instructing Party & Billing Details - Law Firm Name & Office Address:

Instructing Solicitor / File Handler Name:

Direct Contact Email:

Direct Contact Phone Number:

Accounts/Billing Contact Email & Reference:

Law Firm / Claim Reference Number:

Party Represented: Claimant / Plaintiff, Defendant, or Joint Instruction (Single Joint Expert):

2. Subject / Examinee Details - Full Name of Examinee / Subject

Examinee Date of Birth:

Examinee Address:

Examinee Phone number:

Need for Special Accommodations: Interpreter required (specify language), chaperone requested, mobility/access needs

3. Scope of Work & Case Logistics - Type of service required

Jurisdiction & Relevant Rules: (e.g., Civil Procedure Rules / Federal Court Rules)

Specific Legal / Medical Issues to Address: Checkboxes or text area for key questions:

4. Timelines & Deadlines - Report Due Date Requested:

Court / Exchange Deadline (if applicable):

Scheduled Trial or Hearing Date (if applicable):

Rules Civil Claim

Urgency Indicator: Standard (14–28 days) vs. Expedited Service (fee surcharge applies):