Expert Enrollment Form

Expert Strategy Group - Expert Enrollment Form

You may accept or decline our cases for any reason, and our expert network is closed to the public.

There is no charge to list with our service or to work with us.

Approval to work with an Expert referral service

Working with our referral service means that you will be paid by Expert Strategy Group and not the law firm.

Select or enter value

I agree

I agree not to contact any law firm or attorney referral by phone, email, or otherwise that Expert Strategy Group refers to me without our prior approval by Expert Strategy Group. (Check the box to agree.)

Your Name

Your Title (post-nominals)

MD, PhD, Ms, NLCP, RN, etc.

Email address

Non-University or personal email address.

Cell phone number

Phone

City

State

Select

Zip code

Expertise

What is your general area of Expertise?

Examples: Medical, Engineering, Technology, Financial, Computer, Real Estate, etc.

Please describe your expertise in more detail.

Three to ten keywords that describe your area of expertise or a BIO.

These are some of the keywords we will use as search terms to match you with potential cases.

Medical Expert

Yes

Board Certified in

Percentage of time you see patients

Select or enter value

Type of medical facility you work in

Will you accept Medical Malpractice cases?

Do you offer IMEs? Independent Medical Exams

Yes

Types of surgery

Area of the body you specialize in

Age of patients

Select or enter value

States you are licensed

Select or enter value

Have you ever had to pay a fine?

Have you ever had to pay a fine to reinstate your license?

Yes

I do not have any pending legal matters against me

True

False

Testimony Experience

Deposition Experience

Number of times you have testified at a deposition in the past five years.

Testimony Experience

Number of times you have testified at a trial in the past five years

Date of your last testimony

Percentage of plaintiff to defense cases

Select or enter value

Have you had testimony disqualified or excluded?

How many expert reports have you written?

Select or enter value

Your Fees - This section is optional, if you did not include a Fee Schedule

Retainer amount

Retainer check delivery

Select or enter value

Hourly rate for consultation, report preparation

Tell us more. Optional.

Have you worked with a referral service before?

Yes

Can you share the name of the referral service?

Law Firm References

Advertising Bio

Can you include a short bio about yourself that you would like us to use for marketing?

Continuing Legal Education - Speaker?

Please contact me for CLE and speaking engagement opportunities.

Select or enter value

Upload your CV, Fee Schedule, Testimony List, Photo, Etc.

File Upload

*CV

*Fee schedule

Testimony list (optional)

Writing Sample

References (optional)

Drag and drop files here or

Thank you for your interest in working with Expert Strategy Group.

We will contact you with cases that match your expertise.

Please contact us if you have any questions.

Expert Strategy Group

Expert Enrollment Team

Charlotte Fulkerson

ExpertEnrollment@ExpertSG.com

Julie Olejnik Brown

CEO - Founder

JulieO@ExpertSG.com

Ph. 702-789-1008

ExpertSG.com

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