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The Bernstein Approach
 

Heart Attack Misdiagnosis

Step 2 of 3

Please tell us more about the injured person:

Injured person's first name: required field
Injured person's last name: required field
Address:
City:
State:
Zip:
Area code & phone number:
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Age:
Gender: Male Female
______________________________

Please tell us about the injury:
Date of injury:
Doctor/hospital - Name:
Doctor/hospital location - City:
Doctor/hospital location - State:
Briefly describe how you feel the misdiagnosis happened:
What treatment are you getting now for the heart condition?
Date you discovered misdiagnosis:
______________________________
Did you previously consult another attorney about this injury?
Yes No
Is another attorney currently involved?
Yes No

required field = Required Why?

 
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