Expert Disclosure Statement Template

[Name of Court]
[County / District]
[State]

[Plaintiff Name],
Plaintiff,

v.

[Defendant Name],
Defendant.

Case No.: [Case Number]

Expert Disclosure Statement of [Disclosing Party Name]

1. Disclosing Party Information

The following Expert Disclosure Statement is made by [Plaintiff / Defendant / Petitioner / Respondent / Other], [Disclosing Party Name], in the above-captioned matter.

This disclosure is provided pursuant to:

[Applicable rule, scheduling order, stipulation, or court requirement]

2. Expert Identification

The expert witness being disclosed is:

Full Name: [Expert Full Name]
Professional Title: [Title]
Business or Practice Name: [Company / Firm / Practice Name]
Address: [Street Address]
City, State, ZIP Code: [City, State, ZIP Code]
Phone Number: [Phone Number]
Email Address: [Email Address]

Field of Expertise:

[Medical / Engineering / Accounting / Valuation / Accident Reconstruction / Vocational / Other]

3. Subject Matter of Testimony

The expert is expected to testify concerning the following subject matter:

[Describe the general areas, issues, or questions on which the expert may testify]

4. Summary of Opinions

The expert is expected to offer opinions including, but not limited to, the following:

1. [Opinion Summary 1]

2. [Opinion Summary 2]

3. [Opinion Summary 3]

4. [Opinion Summary 4, if applicable]

This summary is intended to provide notice of the substance of the expert’s expected testimony and may be supplemented as permitted by court order or applicable rules.

5. Basis and Reasons for Opinions

The expert’s opinions are based on the following information, methodology, observations, training, education, experience, or analysis:

[Describe the basis and reasons for the opinions]

This may include review of records, interviews, inspections, testing, calculations, photographs, reports, deposition testimony, financial documents, medical records, or other relevant materials.

6. Materials Reviewed or Considered

In forming the opinions expected to be offered, the expert reviewed or considered the following materials:

• [Document or material 1]

• [Document or material 2]

• [Document or material 3]

• [Document or material 4]

• [Additional items, if applicable]

If additional materials are reviewed later, they may be identified in a supplemental disclosure if required or permitted.

7. Qualifications

The expert’s qualifications include the following:

Education:

[Degrees, institutions, relevant training]

Licenses or Certifications:

[License, certificate, registration, or specialty credentials]

Professional Experience:

[Relevant employment, practice history, consulting work, or industry experience]

Specialized Knowledge or Skill:

[Relevant expertise supporting testimony]

A curriculum vitae or resume:

☐ Is attached
☐ Will be provided separately
☐ Is not attached at this time

8. Compensation

The expert’s compensation for review, analysis, preparation, testimony, or related services is as follows:

[Hourly rate / flat fee / other compensation structure]

If additional charges apply for travel, deposition, hearing, or trial testimony, state them here:

[Describe rates or charges]

9. Prior Testimony and Publications

If required by the applicable rule or court order, the following information is provided:

Prior testimony in other matters:

[Describe prior testimony, list cases, or write “To be provided separately if required”]

Publications, articles, or authored materials relevant to the expert’s field:

[List publications or write “None” or “To be provided separately if required”]

10. Exhibits or Supporting Attachments

The following documents are attached or may be attached in support of this disclosure, if applicable:

☐ Resume or curriculum vitae
☐ Written expert report
☐ Fee schedule
☐ List of materials reviewed
☐ Prior testimony list
☐ Publications list
☐ Other: [Describe]

11. Reservation of Rights

The disclosing party reserves the right to supplement, amend, clarify, withdraw, or update this Expert Disclosure Statement as allowed by the court’s scheduling order, applicable procedural rules, or newly obtained information.

Nothing in this disclosure is intended to waive objections, privileges, work-product protections, or any right to challenge the scope, admissibility, or weight of testimony offered by any witness.

12. Declaration or Signature

I certify that the information contained in this Expert Disclosure Statement is provided for purposes of this case and is true and correct to the best of my knowledge, information, and belief.

Date: [Date]

Signature: __________________________
Name: [Attorney Name or Party Name]
Title: [Attorney for Disclosing Party / Self-Represented Party / Other]
Law Firm, if applicable: [Law Firm Name]

13. Contact Information for Counsel

Attorney Name: [Attorney Full Name]
Bar Number: [Bar Number, if applicable]
Law Firm: [Law Firm Name]
Address: [Street Address]
Phone Number: [Phone Number]
Email Address: [Email Address]

Attorney for: [Disclosing Party Name]

14. Certificate of Service

I certify that on [Date], a true and correct copy of this Expert Disclosure Statement was served on the following party or counsel:

Name: [Recipient Name]
Law Firm or Party Name: [Name]
Address: [Address]
Email Address: [Email Address]

Method of Service:

☐ Electronic service
☐ Mail
☐ Hand delivery
☐ Filing system service
☐ Other: [Describe]

Signature: __________________________
Name: [Name of Person Serving Document]
Date: [Date]