INFORMATION FOR DOCTORS
Agreement Form

This form should be printed out, signed, dated and sent to us by regular mail along with a check for $100 to: LawPhysicians, 130 La Casa Via, Bldg. 2 Suite 106, Walnut Creek, CA 94598. Please include the Consultant Information Form and your CV if not previously sent to us. A business card is also helpful. If you do not have a printer, please contact us by e-mail or telephone and we will send you the forms. If you are accepted, we will sign and date the Agreement and return it to you for your records.

This Agreement is concluded between

__________________________________________________________________
(Name, Professional Degrees)
hereafter called "consultant", and Painsolver Inc's LawPhysicians, hereafter referred to as "LP."

Obtain a printable copy

1. In return for advance payment of a $100 registration fee, LP will add the consultant's name to its list of experts in the medical, dental, psychological, scientific or forensic category and/or any paramedical or research categories desired by the consultant. Submission of a current curriculum vitae (CV, resume) acceptable to LP is mandatory before any potential consultant can be listed or any referral made.

2. Upon request, LP will provide the consultant's name and CV to attorneys, physicians, insurance company representatives or other appropriate clients requiring expertise in the consultant's field. No referral will be made without the consultant's prior approval.

3. An hourly fee will be established in advance with appropriate provision for case review, depositions, trial testimony or other contingencies such as out of town travel. No work shall be done by the consultant until notification that an initial deposit (retainer fee) has been received by LP.

4. Consultant agrees to submit all bills for services rendered to a client to LP for payment. No direct billing of a client by the consultant is permitted. Non-compliance with this requirement will result in dismissal of the expert from the LP panel. Periodic billing by the consultant is required so that the client may be notified when additional funds are required. Service fee by LP is 25% of submitted hourly charges unless otherwise agreed upon in writing. Reasonable expenses such as postage, telephone, secretarial and appropriate travel must be itemized and will be reimbursable to the consultant.

5. While LP cannot guarantee work for its expert panel members, it does have a widespread marketing and promotional campaign to potential clients nationwide. Selection of consultants will be made by LP based on client needs and consultant's preferences. If LP is unable to provide work for the consultant after one year, $75 of the registration fee is refundable on written request.

 

By____________________________________ Date_____________
                                (Consultant)