Medical Malpractice Retainer

MEDICAL MALPRACTICE RETAINER

This Medical Malpractice Retainer Agreement (the Agreement) is entered into as of by and between Client Name: , Client Address: (hereinafter "Client") and Attorney/Law Firm Name: , Principal Attorney: , Firm Address: (hereinafter "Attorney").

RECITALS

WHEREAS, Client alleges that medical care provided by one or more health care providers resulted in injury, trauma or loss to Client as more fully described below; and

WHEREAS, Attorney represents that Attorney is duly licensed to practice law and has experience in prosecuting medical malpractice and professional negligence claims; and

WHEREAS, Client desires to retain Attorney to investigate, prosecute and, if appropriate, settle Client's claims against the providers and facilities identified below on the terms set forth in this Agreement.

Primary Allegation / Date of Incident: ; Providers/Facilities Involved:

NOW, THEREFORE

In consideration of the mutual promises contained herein, and other good and valuable consideration, the receipt of which is hereby acknowledged, the parties agree as follows.

1. ENGAGEMENT

Client hereby retains Attorney to represent Client in investigating and pursuing claims for medical malpractice and related damages arising from the incident described above, including pre-suit investigation, negotiation, preparation and prosecution of litigation, appeals, and collection of any recovery (the Representation). Attorney accepts the retention on the terms set forth in this Agreement.

2. SCOPE OF REPRESENTATION

Attorney shall perform legal services reasonably necessary to pursue the claims, which may include review of medical records, retention of expert witnesses, drafting pleadings, conducting discovery, appearing at hearings, negotiating settlement, and taking reasonable steps to collect any judgment or settlement. Unless otherwise agreed in writing, Attorney is not retained to pursue unrelated claims, to represent Client in criminal matters, or to provide medical opinions.

3. ATTORNEY'S FEES

Client and Attorney agree that Attorney's compensation shall be determined as follows (check one):

Contingency Fee Agreement If contingency fee selected, Client agrees that Attorney shall receive as attorney's fees a percentage of the gross monetary recovery (before deduction of costs and expenses) as follows:
    Settlement or recovery prior to filing suit: ;
    Settlement or recovery after filing suit but prior to trial: ;
    Recovery after trial: .

Hourly / Alternative Fee Arrangement If hourly or alternative arrangement is selected, Client agrees to pay Attorney's hourly rates and retainers as set forth: Hourly rate: $. Initial retainer deposit: $ (to be applied against fees and expenses in accordance with Attorney's billing statements).

If both boxes are checked, contingency terms will govern the claim unless otherwise modified in a written amendment signed by both parties.

4. COSTS AND EXPENSES

Client shall be responsible for costs and disbursements incurred in connection with the representation, including but not limited to: filing fees, service of process, deposition and transcript costs, expert witness fees, medical record reproduction, travel, investigative fees, and other reasonable out-of-pocket expenses. Attorney may advance such costs and expenses on Client's behalf but Client remains obligated to reimburse Attorney from any recovery.

All costs and expenses advanced by Attorney shall be a first charge on any recovery and shall be repaid to Attorney before distribution to Client. If there is no recovery, Client remains responsible for costs advanced under any hourly arrangement or if otherwise agreed in writing.

5. CALCULATION OF NET RECOVERY

For purposes of this Agreement, "Gross Recovery" means the total amount recovered from any settlement, judgment, award or other recovery before deductions. "Net Recovery" means Gross Recovery less (a) costs and expenses advanced by Attorney; (b) reasonable and customary costs of administration and collection; and (c) liens, subrogation claims, medical providers' outstanding bills, statutory offsets, or other lawful deductions. Attorney's fee shall be calculated on the Gross Recovery as set forth in Section 3, unless otherwise required by law, in which case the calculation will be adjusted to comply with applicable statutory priorities or lien obligations.

6. CLIENT COOPERATION

Client shall cooperate fully with Attorney, provide truthful information, execute documents as necessary, attend meetings, depositions and hearings, and assist in the prosecution of the claim. Failure to cooperate may be deemed cause for Attorney's withdrawal and may affect Attorney's right to fees and costs as provided in this Agreement.

7. CONFLICTS AND WITHDRAWAL

Attorney shall promptly advise Client of any actual or potential conflict of interest that would materially affect the representation. Attorney may withdraw for good cause, including Client's failure to cooperate, failure to pay agreed-upon fees or costs, or any conflict that cannot reasonably be cured. If Attorney withdraws or is discharged, Attorney may seek reimbursement for reasonable fees and expenses incurred to the date of withdrawal and may assert a charging lien or retain documents as permitted by law.

8. CONFIDENTIALITY AND PRIVACY

Attorney will maintain the confidentiality of information provided by Client to the extent required by law and the rules of professional conduct. Client authorizes Attorney to disclose such information as necessary to pursue the Representation, including disclosure to experts, opposing counsel, courts, and other third parties as required to prosecute the claim.

9. TERMINATION AND EFFECT OF TERMINATION

Either party may terminate this Agreement upon written notice to the other. Termination does not relieve Client of the obligation to pay reasonable fees and costs incurred prior to termination. If Attorney is discharged without cause, Attorney is entitled to compensation under the contingency or hourly terms for services rendered and costs advanced to the date of discharge, and to any reasonable quantum meruit recovery if applicable.

10. ATTORNEY'S LIEN

Client grants Attorney a lien on any and all rights to recovery in this matter for fees and costs advanced, including the right to withhold distribution pending resolution of any fee dispute. Attorney's lien extends to settlement proceeds, judgment proceeds, and any insurance proceeds attributable to the claim.

11. NOTICES

All notices required or permitted under this Agreement shall be in writing and delivered to the addresses provided above by hand, courier, certified mail, or electronic mail with confirmation where agreed by the parties. Notice is effective upon receipt.

12. GOVERNING LAW; DISPUTE RESOLUTION

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to conflict of laws principles. Any dispute arising out of or relating to this Agreement or Attorney's fees shall be resolved in a court of competent jurisdiction in that state unless the parties agree in writing to an alternative dispute resolution procedure.

13. ENTIRE AGREEMENT; AMENDMENT; SEVERABILITY; WAIVER

This Agreement constitutes the entire agreement between the parties regarding the subject matter hereof and supersedes all prior agreements and understandings, whether written or oral. This Agreement may be amended only by a writing signed by both Client and Attorney. If any provision of this Agreement is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect. Failure to enforce any provision shall not constitute a waiver of that provision or the right to enforce it subsequently.

14. COUNTERPARTS

This Agreement may be executed in counterparts, each of which will be deemed an original and all of which together shall constitute one instrument. Signatures delivered electronically or by facsimile shall be treated as original signatures for all purposes.

15. ACKNOWLEDGMENTS

Client acknowledges that Client has read this Agreement, that Attorney has explained the nature and effect of the terms herein, that Client has had the opportunity to ask questions and obtain independent legal advice if desired, and that Client understands and accepts the terms of this Agreement.

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