New Jersey Complaint for Medical Malpractice regarding Diagnosis and Treatment

State:
Multi-State
Control #:
US-CMP-10041
Format:
Word; 
Rich Text
Instant download

Description

This is a model Complaint for damages caused by the negligence of a medical provider whose staff physician negligently failed to diagnose a common medical condition, resulting in severe mental and physical pain and unnecessary medical treatment, tests and associated expense over a period of months. The problem was later properly diagnosed and treated by a second provider. Damages are sought from the first provider. Adapt to fit the circumstances of your case. Care must be used to comply with the law and court rules for your state, because this is a model form.
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FAQ

State medical boards are the agencies that license medical doctors, investigate complaints, discipline physicians who violate the medical practice act, and refer physicians for evaluation and rehabilitation when appropriate.

Otherwise, you may make an anonymous complaint at the Department of Health complaint hotline by calling 800-792-9770, 24 hours a day.

The New Jersey State Board of Medical Examiners' primary responsibility and obligation is to protect the citizens of New Jersey through proper licensing and regulation of physicians and some other health care professionals.

Additionally, the Board of Medical Examiners may be reached by phone at (609) 826-7100.

If you still wish to remain anonymous, please file your complaint by calling 1-800-792-9770. This form can be used to report complaints about licensed health care facilities under the jurisdiction of the Division of Health Facilities Evaluation and Licensing.

Otherwise, you may make an anonymous complaint at the Department of Health complaint hotline by calling 800-792-9770, 24 hours a day. Complaints about New Jersey physicians are processed by the Board of Medical Examiners, a subsidiary of the New Jersey Division of Consumer Affairs.

STEP 1: Fill out the Complaint (Form A) ... STEP 2: Fill out the Civil Case Information Statement (CIS) ... STEP 3: Make a check or money order payable to Treasurer, State of New Jersey in the. STEP 4: Check your completed forms and make copies. ... STEP 5: Mail or deliver the forms to the court.

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New Jersey Complaint for Medical Malpractice regarding Diagnosis and Treatment