Fill and Sign the Attorney Malpractice Complaint Form

IN THE ___________ COURT OF ____________ (County), ____________ (State) _______________________ PLAINTIFF (Name of Plaintiff) V. CAUSE NO. _____,______ _______________________ DEFENDANT (Name of Defendant) Complaint for Malpractice COMES NOW ________________ (Name of Plaintiff) , Plaintiff in the above- styled and numbered cause, by and through his attorney, and files this his Complaint against Defendant, ___________________ (Name of Defendant) , and in support thereof would show unto the Court the following matters and facts: 1. Plaintiff is an adult resident citizen of ___________________________________ (city, county, state) . 2. Defendant is an adult resident citizen of ________________________________ (city, county, state) where he may be served with process. 3. At all times mentioned in this Complaint , Defendant was and still is a physician licensed to practice such profession as provided by the laws of the State of _____________________ (name of state) . Defendant is engaged in practice at _________________________________________________________ (street address, city, state, zip code) . 4. On __________________ (date) , Plaintiff employed Defendant to treat Plaintiff professionally for (specify general character of disease or injury) _______________ _____________________________________________________________________. 5. At that time Defendant undertook as physician and surgeon to (specify general nature of services undertaken) __________________________________________ _____________________________________________________________________. 6. Defendant, in endeavoring to (specify general nature of services) _________ ______________________________________________________________________ _____________________________________________________________________, did not exercise the degree of care or skill ordinarily exercised by others of this profession in the state of _______________ (name of state) in the following ways: (specify the facts that show Defendant’s negligence) _______________________ ______________________________________________________________________ _____________________________________________________________________ . 7. As a proximate result of Defendant's negligence, Plaintiff received the following injuries: (description of injuries) _________________________________________ ____________________________________________________________________. 8. As a further proximate result of the above-mentioned negligence, (specify facts as to general and special damages) ______________________________________ ______________________________________________________________________ _____________________________________________________________________. Wherefore, Plaintiff requests judgment as follows: 1. For damages according to proof; 2. For prejudgment interest in the sum of ____% per year; 3. For costs of suit; and 4. For such further relief as the Court deems just. Respectfully submitted, ___________________________ (Name of Plaintiff) By: _______________________________ (Name of Plaintiff’s Attorney) State Bar No. _____________ His Attorney OF COUNSEL: _________________________ (Name of Plaintiff’s Attorney) Post Office Box ____________ ________________________________ (City, State, Zip Code) Telephone: _________________