1. Treatment and timing
- ☐ Date the relevant treatment began
- ☐ Date of the procedure, decision, delay, or event being questioned
- ☐ Date the injury or problem was discovered
- ☐ Date of later diagnosis or corrective treatment
2. Providers and facilities
| Provider / facility | Specialty / role | Date range | Records received? |
|---|---|---|---|
3. What happened
- Write the medical decision or omission you want reviewed in one sentence.
- List the information available to the provider at that time.
- Describe the later injury or additional treatment using records where possible.
- List alternative medical explanations you think an expert may need to consider.
4. Records
- Complete relevant chart
- Imaging and laboratory results
- Medication and pharmacy records when relevant
- Billing records
- Portal messages and call logs
- Later treatment and second-opinion records
5. Questions for counsel
- Which state deadline and pre-suit rules could apply?
- What medical specialty should review the care?
- What additional records are needed?
- What facts currently make causation stronger or weaker?
- How are contingency fees, expert costs, and litigation expenses handled?
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