Confidential Intake

Tell us what’s happening. Early.

The single most common regret we hear is “I waited.” This takes about ninety seconds. Answer what you know and leave the rest blank. We follow up either way, and there is no cost to send it.

Read this before you fill anything in

Sending this form does not create an attorney client relationship, and nothing here is legal advice. A relationship begins only when we and you sign a written engagement agreement, after a conflicts check. Until then we are not your lawyers and we may be unable to take your matter.

Protection for what you send is limited before an engagement exists, and a detailed unsolicited disclosure can itself prevent us from helping you. So keep this short: no documents, no patient information, no names of individuals, no long account. Save the detail for the call, and use a personal email and a personal device rather than a hospital account.

How to reach you

Use a personal address, never your hospital or program email.

The fastest route if something is time sensitive.

Your training

Public or private changes which rights apply. A best guess is fine.

What has happened so far? Select all that apply.
Deadlines

A hearing, an appeal window, a response due date, a meeting. If one exists, this is the most important answer on the form.

A remediation plan, a resignation, a release, a settlement. If yes, please do not sign before we speak.

600 characters left. Keep it to logistics and dates. No names, no patient details, no documents. We will ask for those properly once we can.

A note on patient information

Please describe clinical events without patient names, dates of birth, or record numbers. A general description is enough for us to help.

Before you talk to anyone

  • Do not resign, sign, or agree to anything until counsel has read it: not a “mutual separation,” not a release, not a remediation plan.
  • Use personal devices and personal email only. Assume anything on hospital systems is visible to the institution.
  • Preserve everything: texts, emails, call logs, schedules, evaluations, policies, the handbook, and the dates on all of it.
  • Put your side in writing, dated, while your memory is fresh: factually, without adjectives.

Not ready to reach out? Do this instead.

Send this site to one resident who needs it. Most residents find out their handbook was enforceable only after their deadline had passed.