Medical Expert Onboarding Form For consultants, surgeons, clinicians, and healthcare specialists joining Medical Legal Doctors Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Full name *FirstLastDate of Birth *Email *Mobile number *AddressAddress Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryCurrent job title *Speciality/sub-speciality *Qualifications *Current employer/practice *Years of experience in specialityProfessional registration body *GMCGDCHCPCNMCOtherRegistration number *Licence to practise *YesNoSpecialist Register (if applicable) *YesNoN/AHave you written medico-legal reports before? *YesNoApproximate number of reports completed *Types of reports previously prepared *Personal injuryClinical negligencePost-mortem commentaryCriminal injuryPrognosis reportsOtherHave you attended court or been cross-examined? *YesNoDo you require training or guidance on medico-legal report writing? *YesNoDo you hold professional indemnity/medico-legal insurance? *YesNoProvider *Policy number * you body Website Level of cover *Expiry date *Please upload evidence of insurance * Click or drag files to this area to upload. You can upload up to 50 files. Documents Required *CVProof of IDProof of addressRegistration certificate or online register linkQualifications/certificatesInsurance certificateRecent professional photograph (for potential website use)Website Consent: Are you happy for Medical Legal Doctors to use your name, photograph, qualifications, speciality, registration details, and professional profile on our website and marketing materials? *YesNoConfidentiality, Non-Disclosure & Client Contact *I understand and agree that any work offered through Medical Legal Doctors is confidential.I agree that I will not contact, approach, solicit, or accept instructions directly from any lawyer, legal firm, claimant, defendant, client, patient, agency, insurer, or third party introduced through Medical Legal Doctors unless written permission is provided.I agree that each assignment may require a separate NDA or confidentiality undertaking.Date *Fees & Availability: Preferred hourly/report rate *Availability for urgent work *YesNoTypical turnaround time for reports *Preferred method of contact *Fees & Availability acknowledgement *I understand that remuneration will be agreed separately before each assignment begins.Declarations *I am currently in good standing with my professional regulator.I have no restrictions, suspensions, or ongoing fitness-to-practise issues, or I have disclosed them below.I will maintain appropriate insurance while undertaking work.I will declare any conflict of interest before accepting an instruction.I will provide independent, objective, evidence-based opinions.I understand my duty is to the court/tribunal where applicable, not solely to the instructing party.Disclosure details (if any)Date (Declarations)Submit