Expert Disclosure Statement Template
[Attorney Name or Party Name]
[Law Firm Name, if applicable]
[Address]
[City, State, ZIP Code]
[Phone Number]
[Email Address]
IN THE [NAME OF COURT]
FOR [COUNTY / DISTRICT / JURISDICTION]
[Plaintiff / Petitioner Name],
Plaintiff / Petitioner,
v.
[Defendant / Respondent Name],
Defendant / Respondent.
Case No.: [Case Number]
1. Title of Disclosure
EXPERT DISCLOSURE STATEMENT
[Name of Party] submits this Expert Disclosure Statement concerning the expert witness identified below.
This disclosure is made subject to the applicable rules, court orders, scheduling requirements, and any right to supplement or amend as permitted.
2. Party Making Disclosure
Disclosing Party: [Plaintiff / Defendant / Other Party Name]
Counsel for Disclosing Party, if applicable:
[Attorney Name]
[Law Firm Name]
[Address]
[Phone Number]
[Email Address]
Expert Name: [Full Name]
Business Address: [Address]
Phone Number: [Phone Number]
Email Address: [Email Address]
Field of Expertise: [Specialty / Profession / Discipline]
Relationship to Case:
☐ retained expert
☐ specially employed expert
☐ employee expert
☐ non-retained expert
☐ treating professional / hybrid witness
☐ other: [Describe]
4. Type of Disclosure
This disclosure is being made as:
☐ full expert report disclosure
☐ summary expert disclosure
☐ rebuttal expert disclosure
☐ supplemental expert disclosure
☐ other: [Describe]
If a full written report is attached, identify it here:
[Report title, date, and attachment reference]
5. Subject Matter of Testimony
The expert is expected to testify regarding the following subject matter:
[Describe subject matter]
Additional subject areas, if any:
[Insert details]
6. Opinions to Be Offered
The expert is expected to offer the following opinions:
Opinion 1: [State opinion]
Opinion 2: [State opinion]
Opinion 3: [State opinion]
Additional opinions, if any:
7. Basis and Reasons
The basis and reasons for the expert’s opinions include:
[Describe methods, analysis, review, calculations, testing, experience, or other grounds]
8. Facts or Data Considered
The expert considered the following facts, data, materials, or information in forming the opinions:
[Medical records / business records / photos / test results / contracts / deposition testimony / site inspection / financial data / other materials]
Additional facts or data, if any:
9. Exhibits or Materials Supporting Opinions
The following exhibits, charts, summaries, reports, demonstratives, or other materials may be used to summarize or support the expert’s opinions:
Exhibit or Attachment 1: [Description]
Exhibit or Attachment 2: [Description]
Exhibit or Attachment 3: [Description]
Additional supporting materials, if any:
10. Qualifications of Expert
The expert’s qualifications include:
[Education]
[Licenses or certifications]
[Professional experience]
[Specialized training]
[Positions held]
[Other qualifications]
Curriculum vitae or resume attached:
☐ yes
☐ no
11. Publications
Publications authored by the expert in the previous 10 years, if required or applicable:
[Insert list or state “See attached curriculum vitae”]
12. Prior Testimony
Cases in which the expert testified at trial or by deposition during the previous 4 years, if required or applicable:
[Case Name / Court / Year / Type of testimony]
Additional prior testimony information, if any:
13. Compensation
Compensation to be paid to the expert for study, review, preparation, testimony, or appearance in this matter:
[Hourly rate / flat fee / deposition rate / trial rate / other compensation terms]
14. Rebuttal or Limitation Notes
If this is a rebuttal or limited disclosure, state the limitation here:
[Describe the opposing expert or subject matter being rebutted, or any scope limitation]
15. Reservation and Supplementation
This disclosure is based on information reasonably available as of the date below.
The disclosing party reserves the right to amend, supplement, revise, narrow, or withdraw this disclosure as permitted by applicable rule, court order, evidentiary ruling, stipulation, or trial developments.
16. Signature
Dated: [Date]
Signature: __________________________
Name: [Attorney Name or Party Name]
Title: [Attorney for Party / Self-Represented Party / Other]
Bar Number: [Bar Number, if applicable]
17. Certificate of Service
I certify that on [Date], I served this Expert Disclosure Statement on the following person(s) or party(ies):
[Name] – [Address / Email]
[Name] – [Address / Email]
Method of Service:
☐ email
☐ electronic filing system
☐ mail
☐ hand delivery
☐ other: [Specify]
Signature: __________________________
Name: [Attorney Name or Party Name]
Date: [Date]