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Our Physicians
Christian Athanassious, M.D.
Thomas W. Axelrad, MD, PhD
Thomas C. Degenhardt, M.D.
Michael J. McDermott, M.D.
Dominic J. Mintalucci, M.D.
Michelle Nentwig, M.D.
Neema Pourtaheri, M.D.
Mark E. Schakel, M.D.
Gary A. Stein, M.D.
Physician Assistants
Rodney Gerrit DeKleuver NCCPA
Jason Evan Justin, NCCPA
Sarah Swanson NCCPA
Therapy Team
Hayden Block, DPT
Benjamin Baumgardner, DPT
Anna R. Coopersmith, OTRL, CHT
Kyle Garcia, OTR/L
Candyce Powell, PT
Rena Ribeiro, OTR/L
Michael Serrano, PTA
Aanal Shah, DPT
Sarah Sizemore, OTR, L
Cynthia Syiek MA, ORT/LCHT
Medical Legal Request Form
Medical Legal Request Form
SROrtho
2022-09-09T19:01:31-07:00
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Independent Medical Exam (IME)
Review of Records with Report
Expert Witness Engagement
Deposition
Telephone Conference
Please complete the information below to request medical legal services.
Is this a Subpoenaed Request?
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Is this a work related injury?
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Medical Expert Requested (select from menu) 🡳
Christian Athanassious, M.D.
Thomas W. Axelrad, MD, PhD
Frederick S. Bennett, M.D
Thomas C. Degenhardt, M.D.
Kai-Uwe Mazur, M.D.
Michael J. McDermott, M.D
Dominic J. Mintalucci, M.D.
Neema Pourtaheri, M.D.
Mark E. Schakel, M.D.
Gary A. Stein, M.D.
Please choose an expert for us.
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Last
Firm/Company Name
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Firm/Company Address
*
Requestor Email
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Requestor phone
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Case Name
*
Case Type
*
(Personal Injury, Labor & Employment, Product Liability, etc.)
Claimant/Plaintiff Name
*
First
Last
Claimant/Plaintiff DOB
*
Opposing Counsel
Claimed Injuries
*
Timeframe Needed
Additional instructions/Information
Thank you for your interest in working with our Medical Experts. A member of our team will contact you within 24 hours of receipt. Your request is of the utmost importance to us and we shall keep your information confidential. Please be advised that your request does not guarantee our acceptance of this case, nor can the assumption be made that we are actively working on this matter until a member of our team contacts you. By clicking on submit you agree to these terms.
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