Form: APRN Intake APRN Directory Intake First Name Last Name Email Phone * we will need to call you when an attorney wants to hire you Do you consent to text messages for communication? * I consent to text notifications such as cases I have been selected for Please communicate by email and phone only Desired Level AssociatePartnerSenior PartnerTeam Member You will need to have your professional headshot and your CV/resume available prior to proceeding. * I have both my headshot and my CV ready to upload Please email me further instructions for later Professional Headshot * Drop a file here or click to upload Choose File Maximum file size: 33.55MB Can be AI but must look realistic. https://geekflare.com/ai-headshot-generators/ Three sentence clinical experience bio in third person * 0 of 150 max words Three paragraph expanded bio 0 of 700 max words Terms and Condition Terms and Conditions Associate and Partner Level Terms and Conditions Review Personal Information use Your listing on the Discovery NP Legal Consultants directory is at the discretion of our admin team. Should you become ineligible to continue on the directory for any reason, or for no reason at all, you will be notified of this decision by email, your subscription will be discontinued, and your card will not be charged for any future payments. By applying for our directory, you consent to the following regarding your personal information: Collection and Use. We may collect and use your personal information to maintain a directory of professionals. Unless you opt out, we will send updates on our products/services, and inform you about partner services that may interest you. If not accepted to the directory immediately, we may retain your contact information indefinitely and reach out when a spot becomes available Sharing with Attorney Clients. Your information, including CV, fee schedule, headshot, and contact details as applicable to your membership level, may be sold to or shared with any attorney or law firm representative who may be seeking expert witnesses or consulting services. Based on your level of membership attorneys may contact you directly, or you may be required to use our free conference call service to make the connections. Your communication with attorneys about the cases will be subject to the non-solicitation clauses below. Third-Party Sales. We do not sell your personal information to third parties, except in the case where we collect a finder's fee to turn over your contact information if selected for a testifying expert role, to which you expressly consent. Your data's security is important to us, but no internet transmission is entirely secure. Recurring payment Recurring payment. By selecting a membership level and payment option, you agree to a recurring monthly or annual payment, depending on the chosen membership plan. Your payment information will be securely stored, and we will automatically process the transaction at the beginning of each billing cycle. By providing your payment details, you authorize us to charge the applicable membership fee to the designated payment method. You understand and acknowledge that the recurring payment will continue until you cancel your subscription. You may cancel your membership at any time before the next billing cycle to avoid future charges. Please note that failure to make timely payments may result in the suspension or discontinuation of your membership. For any concerns or inquiries regarding billing or payment, please contact our support team at admin@nplegalconsultants.com. By agreeing to these terms, you acknowledge that you have read and understood our payment policies and consent to the automatic processing of payments for your selected membership level at the selected interval. Free trial. If you have been offered a free trial, you must cancel before the end of your trial. Once your card has been processed for a billing cycle, you may cancel, but your listing will remain active until the end of the billing cycle. If for any reason we discontinue your listing on our end, you will be prorated a portion of your listing fee corresponding to the time left in the billing cycle. Release of Likeness and Bio: Accurate Representation. You are attesting that the headshot you are submitting is within the last 5 years and represents your current likeness. Rights to Distribute. By submitting your headshot or likeness, as well as the information in your biography and your CV, you grant us the non-exclusive, worldwide, royalty-free right and license to use, reproduce, publish, display, and distribute this content in whole or in part, full or redacted, on our website and in our social media platforms for the purpose of promoting your profile and our services. Minor Edits and Modifications. You affirm that you understand and consent that we may make minor edits, alterations, or modifications to your submitted content and photograph as needed, while ensuring that the essence and accuracy of the content remain intact. You also agree to the generation of alternative AI headshot(s) of your likeness, for which we will request your explicit approval before publishing, and which will only be used to represent you and your services in a professional manner. Such AI generated photo shall be the property of Discovery NP Legal Consultants with unrestricted worldwide rights to royalty-free right and license to use, reproduce, publish, display, and distribute. Questions. If you have any questions, concerns, or objections about the use of your content or any specific alterations or likenesses, please feel free to reach out to our support team at support@nplegalconsultants.com, and we will address them accordingly. Your satisfaction with the presentation of your profile is important to us, and we will work to accommodate your preferences whenever possible. Third party rights. This authorization allows us to showcase your expertise and qualifications to our audience and potential clients. You affirm that you have the right to grant us this license and that the use of your headshot, likeness, and biography will not infringe upon any third-party rights. No promises Variables to success of your listing. By proceeding with the listing and agreeing to these terms, you acknowledge that the success of your listing depends on various factors beyond our control, including, but not limited to, market demand for your specialty, the marketability of your personal listing and experience, and attorney client preferences. While we endeavor to provide a valuable platform for showcasing your expertise and putting you in a favorable light on Google searches for your specialty, we cannot guarantee specific results. No guarantee. By listing yourself on our directory of consultants, you acknowledge and understand that we do not make any promises or guarantees regarding the number of cases or opportunities you may receive from attorney clients as a result of your listing. While we strive to connect you with potential clients seeking your expertise, the frequency or likelihood of case referrals cannot be assured. Edits to your listing. You may request edits to the content of your listing to enhance your attractiveness as a candidate to attorney clients by emailing support@nplegalconsultants.com or by logging in and editing your entries. However your edits will be subject to review, finalization and approval of our support staff. Cancelation of your listing. You retain the right to cancel your listing at any time, and your cancellation will be effective from the next billing cycle. However, please note that no refunds will be issued for any remaining portion of the current billing period upon cancellation. We encourage you to consider this policy before subscribing to our directory services. Questions. If you have any questions or concerns about these terms, please contact our support team for clarification before proceeding with your listing. Your satisfaction and understanding of our services are essential to us, and we are here to assist you throughout the process. Non-Compete Independent APRNs who do not actively market or offer their own independent services as LNCs and who have no private clientele automatically qualify under this clause. In order to be a candidate for a listing with Discovery NP Legal Consultants, an APRN legal nurse consultant who does actively market or offer his or her own services independently must continuously fulfill the following no-compete requirements: You must not have independently reviewed more than 20 cases in the last year outside of Discovery NP Legal Consultants’ referrals to you (exception: APRNs who work exclusively for one law firm may qualify). You and/or your consulting entity must not offer flat-rate (non-hourly) merit reviews outside of Discovery NP Legal Consultants (unless you are Senior Partner level) You must not have any employees as a legal nurse consultant You must not have subcontracted cases to more than one other LNC in the last 6 months (you may refer them to Discovery NP Legal Consultants’ subcontracting service and receive a referal bonus) Your personal or entity’s website must not contain language such as “we, our, ours” in describing your services (First or third person singular is acceptable). Your personal or entity’s website must not advertise consulting services in clinical areas in which you are not personally explicitly clinically trained or experienced. Your hourly rate for consulting services must not be lower than that offered to attorneys by Discovery NP Legal Consultants (inquire in each case for our current rates) You must have an active LinkedIn account, and you must not block Discovery NP Legal Consultants’ admin or Elisa Collins, FNP A determination by annual or random audit or investigation that you no longer qualify for a listing with us will result in discontinuation of your listing upon the next billing cycle. Non-Solicitation Associate and Partner Level Non-Solicitation of clientele and known prospects. You agree never to knowingly solicit Discovery NP Legal Consultants’ attorney-clients on behalf of yourself or others for the performance of medical-legal consulting or testifying services of any kind outside of Discovery NP Legal Consultants’ billing, nor to accept offers of the same from attorney-clients of Discovery NP Legal Consultants nor inquiries made from members of the Discovery NP Legal Consultants’ “Ask an NP-Medical-legal Consultant” LinkedIn Group within that group. Contact Information. You agree never to provide Discovery NP Legal Consultants’ attorney-clients nor attorney-prospects with your personal email address, direct phone number, nor your personal website as an Independent Legal Nurse Consultant, whether requested within our private LinkedIn group or via any other means. Self-Promotion. You may not advertise or publish self-promoting posts within Discovery NP Legal Consultants’ “Ask an NP-Medical-legal Consultant” LinkedIn Group. Clinically educational posts are acceptable without a call to action. You will direct all requests for your contact information obtained via such posts to Elisa Collins, Coordinator of Consulting Services. Anonymous Caller ID. All calls with Discovery NP Legal Consultants’ attorney-clients will be scheduled through Discovery NP Legal Consultants’ call scheduling system (when available) and conducted via Video Conference or Audio Conference as provided by Discovery NP Legal Consultants; or if no such service is provided, calls with Discovery NP Legal Consultants’ attorney-clients shall be conducted in a way that does not display/reveal your personal phone number. One option is the use of dialing *67 prior to dialing the attorney’s phone number. Audits. Calls using Discovery NP Legal Consultants’ Services are subject to recording and audit. Grounds for Immediate Discontinuation. Any single incident of personal solicitation of our attorney-clients will disqualify your listing from that point forward. Consider the Senior Partner Option with a Drastically More Liberal Non-Solicitation Clause Terms and Conditions Senior Partner Level Terms and Conditions Review Personal Information use Your listing on the Discovery NP Legal Consultants directory is at the discretion of our admin team. Should you become ineligible to continue on the directory for any reason, or for no reason at all, you will be notified of this decision by email, your subscription will be discontinued, and your card will not be charged for any future payments. By applying for our directory, you consent to the following regarding your personal information: Collection and Use. We may collect and use your personal information to maintain a directory of professionals. Unless you opt out, we will send updates on our products/services, and inform you about partner services that may interest you. If not accepted to the directory immediately, we may retain your contact information indefinitely and reach out when a spot becomes available Sharing with Attorney Clients. Your information, including CV, fee schedule, headshot, and contact details as applicable to your membership level, may be sold to or shared with any attorney or law firm representative who may be seeking expert witnesses or consulting services. Based on your level of membership attorneys may contact you directly, or you may be required to use our free conference call service to make the connections. Your communication with attorneys about the cases will be subject to the non-solicitation clauses below. Third-Party Sales. We do not sell your personal information to third parties, except in the case where we collect a finder's fee to turn over your contact information if selected for a testifying expert role, to which you expressly consent. Your data's security is important to us, but no internet transmission is entirely secure. Recurring payment Recurring payment. By selecting a membership level and payment option, you agree to a recurring monthly or annual payment, depending on the chosen membership plan. Your payment information will be securely stored, and we will automatically process the transaction at the beginning of each billing cycle. By providing your payment details, you authorize us to charge the applicable membership fee to the designated payment method. You understand and acknowledge that the recurring payment will continue until you cancel your subscription. You may cancel your membership at any time before the next billing cycle to avoid future charges. Please note that failure to make timely payments may result in the suspension or discontinuation of your membership. For any concerns or inquiries regarding billing or payment, please contact our support team at admin@nplegalconsultants.com. By agreeing to these terms, you acknowledge that you have read and understood our payment policies and consent to the automatic processing of payments for your selected membership level at the selected interval. Free trial. If you have been offered a free trial, you must cancel before the end of your trial. Once your card has been processed for a billing cycle, you may cancel, but your listing will remain active until the end of the billing cycle. If for any reason we discontinue your listing on our end, you will be prorated a portion of your listing fee corresponding to the time left in the billing cycle. Release of Likeness and Bio: Accurate Representation. You are attesting that the headshot you are submitting is within the last 5 years and represents your current likeness. Rights to Distribute. By submitting your headshot or likeness, as well as the information in your biography and your CV, you grant us the non-exclusive, worldwide, royalty-free right and license to use, reproduce, publish, display, and distribute this content in whole or in part, full or redacted, on our website and in our social media platforms for the purpose of promoting your profile and our services. Minor Edits and Modifications. You affirm that you understand and consent that we may make minor edits, alterations, or modifications to your submitted content and photograph as needed, while ensuring that the essence and accuracy of the content remain intact. You also agree to the generation of alternative AI headshot(s) of your likeness, for which we will request your explicit approval before publishing, and which will only be used to represent you and your services in a professional manner. Such AI generated photo shall be the property of Discovery NP Legal Consultants with unrestricted worldwide rights to royalty-free right and license to use, reproduce, publish, display, and distribute. Questions. If you have any questions, concerns, or objections about the use of your content or any specific alterations or likenesses, please feel free to reach out to our support team at support@nplegalconsultants.com, and we will address them accordingly. Your satisfaction with the presentation of your profile is important to us, and we will work to accommodate your preferences whenever possible. Third party rights. This authorization allows us to showcase your expertise and qualifications to our audience and potential clients. You affirm that you have the right to grant us this license and that the use of your headshot, likeness, and biography will not infringe upon any third-party rights. No promises Variables to success of your listing. By proceeding with the listing and agreeing to these terms, you acknowledge that the success of your listing depends on various factors beyond our control, including, but not limited to, market demand for your specialty, the marketability of your personal listing and experience, and attorney client preferences. While we endeavor to provide a valuable platform for showcasing your expertise and putting you in a favorable light on Google searches for your specialty, we cannot guarantee specific results. No guarantee. By listing yourself on our directory of consultants, you acknowledge and understand that we do not make any promises or guarantees regarding the number of cases or opportunities you may receive from attorney clients as a result of your listing. While we strive to connect you with potential clients seeking your expertise, the frequency or likelihood of case referrals cannot be assured. Edits to your listing. You may request edits to the content of your listing to enhance your attractiveness as a candidate to attorney clients by emailing support@nplegalconsultants.com or by logging in and editing your entries. However your edits will be subject to review, finalization and approval of our support staff. Cancelation of your listing. You retain the right to cancel your listing at any time, and your cancellation will be effective from the next billing cycle. However, please note that no refunds will be issued for any remaining portion of the current billing period upon cancellation. We encourage you to consider this policy before subscribing to our directory services. Questions. If you have any questions or concerns about these terms, please contact our support team for clarification before proceeding with your listing. Your satisfaction and understanding of our services are essential to us, and we are here to assist you throughout the process. Non-Compete Independent APRNs who do not actively market or offer their own independent services as LNCs and who have no private clientele automatically qualify under this clause. In order to be a candidate for a listing with Discovery NP Legal Consultants, an APRN legal nurse consultant who does actively market or offer his or her own services independently must continuously fulfill the following no-compete requirements: You must not have independently reviewed more than 20 cases in the last year outside of Discovery NP Legal Consultants’ referrals to you (exception: APRNs who work exclusively for one law firm may qualify). You and/or your consulting entity must not offer flat-rate (non-hourly) merit reviews outside of Discovery NP Legal Consultants (unless you are Senior Partner level) You must not have any employees as a legal nurse consultant You must not have subcontracted cases to more than one other LNC in the last 6 months (you may refer them to Discovery NP Legal Consultants’ subcontracting service and receive a referal bonus) Your personal or entity’s website must not contain language such as “we, our, ours” in describing your services (First or third person singular is acceptable). Your personal or entity’s website must not advertise consulting services in clinical areas in which you are not personally explicitly clinically trained or experienced. Your hourly rate for consulting services must not be lower than that offered to attorneys by Discovery NP Legal Consultants (inquire in each case for our current rates) You must have an active LinkedIn account, and you must not block Discovery NP Legal Consultants’ admin or Elisa Collins, FNP A determination by annual or random audit or investigation that you no longer qualify for a listing with us will result in discontinuation of your listing upon the next billing cycle. Non-Solicitation Senior Partner Level Non-solicitation of clientele and known prospects. You agree never to knowingly solicit Discovery NP Legal Consultants’ attorney-clients on behalf of yourself or others for the performance of medical-legal consulting or testifying services of any kind outside of Discovery NP Legal Consultants’ billing, however, you may accept offers of the same from attorney-clients of Discovery NP Legal Consultants and you may respond to inquiries made from members of the Discovery NP Legal Consultants’ “Ask an NP-Medical-legal Consultant” LinkedIn Group within that group. Contact Information. As long as your Senior Partner membership is current, you may provide Discovery NP Legal Consultants’ attorney-clients and attorney-prospects with your personal email address, direct phone number, and/or your personal website as an Independent Legal Nurse Consultant, if explicitly requested within our private LinkedIn group or via any other means. Self-Promotion. Notwithstanding, you may not advertise or publish self-promoting posts within Discovery NP Legal Consultants’ “Ask an NP-Medical-legal Consultant” LinkedIn Group. Clinically educational posts are acceptable without a call to action. Should attorney-clients request your contact information as a result of such postings, you may respond to such inquiries with your personal contact information. Calls with Attorneys. Calls with attorney-clients of Discovery NP Legal Consultants may be conducted in any professional way you feel most suitable to the situation. Non-Compete Notwithstanding these allowances, you and your consulting entity must continually abide by the qualifications set forth in the Non-Compete clause. Acknowledgement of Receipt and Agreement to Terms and Conditions * Signature Clear Social Links LinkedIn Optional. na.com if none Consultant's Credentials Please indicate all degrees obtained in healthcare-related education * MSN DNP MS MD PhD DC DO Please indicate all certification(s) obtained * FNP-C CNP ACHPN ACNP ACONP A/GNP CNM CRNA ENP NNP MD PA-C PMHNP PNP WHNP OtherOther None of these Approximate date you graduated with your RN license Approximate date you graduated with your Provider License Please select ALL specialties in which you have at least TWO years PROVIDER-level experience * Anesthesia Provider Cardiology Provider Cardiothoracic Surgery Provider Chiropractor Dermatology Provider Ear Nose Throat Provider Emergency Services Provider Endrocrinology Provider Gastroenterology Provider General Surgery Provider Hospice/Palliative Care Provider Hospitalist/Internist Provider Intensive Care Medical Provider Interventional Radiology Provider Long Term Care/Nursing Home Provider Neonatal Intensive Care (NICU) Provider Nephrology/Dialysis Provider Neurology Provider Provider Neurosurgery Provider Obstetrics Provider Oncology/Hematology Provider Ophthalmology Providers Orthopedics Provider Osteopathic Provider Pediatrics Provider Plastic Surgery Provider Podiatry Provider Primary Care Provider/ General Practitioner Psychiatry / Mental Health Provider Pulmonology Provider Radiology Provider Rehabilitation Provider Rheumatology Provider Sleep Medicine Provider Spine health Provider Urgent Care Provider Urology Provider Women's Health Provider Wound Care Provider Are you interested in/willing to testify? * Yes, I'm willing No, I'm not interested at all I may be interested; send me some more information This is not required, but many NPs can charge upwards of $200/hr for testifying work. How many times have you been deposed? * This means had a deposition taken under oath outside of a courtroom. If none, please indicate "0" How many times have you testified in a courtroom as an expert witness? * If none, please indicate "0" What % of the cases for which you have served as testifying expert were for the plaintiff's counsel? * 50 Summary If you are human, leave this field blank. NextSubmit Use Shift+Tab to go back
