Instructions

Before submitting this form, please read the following, applicable both to yourself as an individual attorney and to your firm and all attorneys practicing therein.

I am requesting consultation from Physicians for Quality (PFQ), subject to the following:

• I understand that PFQ will provide me the name of a satisfactory expert in exchange for the fee paid and that payment to the expert is my responsibility.
• I understand and agree that all statements made by PFQ in its advertising and this brochure are not representations, express nor implied, but are merely expressions of intent and/or opinion.
• I understand that PFQ does NOT verify the information regarding credentials submitted by participating experts and does NOT otherwise investigate suitability of any expert. In the event that an expert is found to have falsified information, the liability of PFQ is limited to either obtaining another expert or returning any fees paid by me or my firm to PFQ. PFQ is NOT liable for any consequential damages. PFQ is NOT responsible for experts who refuse to testify or who change their opinions, other than to find a replacement or refund the fee paid. Refunds must be timely requested.
• I understand that PFQ will contact the expert directly only for the purpose of making an introduction. Then I will contact the expert and if he or she is unsuitable, I understand that PFQ will either help me to obtain another expert or refund any fees paid by me to PFQ. I agree that this guarantee does not apply if I drop the case, refer it to another attorney, or otherwise do not need an expert due to circumstances not within the control of PFQ.
• I agree NOT to contact independently any expert whose name is provided to me by PFQ for review, consultation, testimony or any similar purpose for any case other than the one named below for a period of ten years from the date of my submission of this form, without first remitting an additional fee of $385 and order form to PFQ; nor to aid another attorney or other party to contact any such expert except in regard to this case. I understand that this includes my voluntarily causing the name of such expert to be published in any publication without prior authorization by PFQ.
• I understand that the services of PFQ are limited by availability. I understand that PFQ will attempt to notify me in a timely fashion (usually within 7 days) if my request cannot be accepted, or if it has been accepted, cannot be granted; but that it is my responsibility to meet any deadlines. I agree that PFQ may unilaterally cancel this order at any time during processing for any reason, simply by returning my fee.
• I understand that PFQ's modest fee reflects my agreement that PFQ, under any circumstance, will not be liable for any amount greater than the fee paid by me.
• I agree to be bound by the terms of this agreement for any future emergency orders I may place by telephone, and to remit my check for $385 and a completed order form so that they are received by PFQ within one week of my placing such telephone order. I understand that failure to remit payment as agreed may result in the notification of any experts supplied by PFQ of my failure to honor financial commitments.