Mr. Russell Miller - Hip, knee & Shoulder Surgeon Your Practice Online
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Medico Legal Online Form
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REQUEST FOR URGENT MEDICO‚ÄźLEGAL ASSESSMENT AND REPORT
Client Name *  
Gender   Male    Female
Client Email Address *  
Client Address     
Date of Birth    Pick a date
Client Mobile Telephone Number *  
Lawyer, Company Name and Branch *  
Lawyer Email Address *  
Lawyer File Reference  
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Lawyer Telephone Number  
How soon is report required?  
Will this appointment be a JME?   Yes    No
In approximately 150 words please describe the number and nature of injury
Does this relate to medical negligence?   Yes    No
Is the Client available for out of hours booking?   Yes    No
The size of the file, i.e how many cm in thickness?    cm
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Mr. Russell Miller - Hip, knee & Shoulder Surgeon
American Academy of Orthopaedic Surgeons Australian Orthopaedic Association
Royal Australasian College of Surgeons International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine