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Filling out the professional liability suit information form is essential for those involved in a liability suit. This guide will provide you with the necessary steps to complete this form online efficiently and accurately.

Follow the steps to complete the form correctly.

1. Press the ‘Get Form’ button to access the necessary form and open it in your preferred online editor.
2. Begin by entering the name of the patient or plaintiff in the designated field. Ensure the name is spelled correctly to avoid any discrepancies.
3. Provide the date of the event related to the suit in the specified section. This should reflect the actual date when the incident occurred.
4. Fill in the date of the suit in the corresponding field. This indicates when the legal action was initiated.
5. Indicate whether the suit involves the death of the patient, wrong-sided surgery, or loss of limb or major organ by marking 'Yes' or 'No' in the relevant section.
6. Clarify your role in the suit or claim by selecting one of the options: primary defendant, co-defendant, or other.
7. For the status of the suit, select from the following options: Pending, Dismissed, or Settled. Based on your selection, provide the necessary documentation as instructed in the form.
8. If the suit is settled, specify the amount settled on your behalf in the designated field.
9. Provide a detailed description of the allegations related to the suit in the section provided.
10. Describe your involvement in the care of the patient thoroughly, as this information is critical for the review process.
11. Print your name in the 'Applicant Name' section and ensure your signature is provided in the 'Applicant Signature' field.
12. Finally, include the date on which you are completing the form before submitting it.
13. Once you have filled out the form completely, you can save changes, download a copy for your records, print the form, or share it as necessary.

Complete your professional liability suit information form online today!