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Request a Conflict Check and Case Review

Use this form to submit a matter for conflict screening. Every engagement begins with a conflict check before any substantive discussion of the facts. After conflicts are cleared, secure transfer instructions and engagement terms will be provided.

Please correct the following before submitting:

Your information

Full name This field is required.

Law firm or organization This field is required.

Professional title This field is required.

Work email A valid email address is required.

Telephone This field is required.

Preferred method of contact This field is required.

Matter information

State This field is required.

Jurisdiction This field is required.

Type of matter This field is required.

Requested service This field is required.

Party you represent or your role This field is required.

Case caption or abbreviated matter name This field is required.

Represented party This field is required.

Opposing party This field is required.

Opposing counsel This field is required.

Party and counsel information is required so that a conflict check can be performed before any substantive discussion of the matter.

The ophthalmic issue

Brief description of the ophthalmic issue This field is required.

Are medical records available? This field is required.

Estimated record volume (optional)

Relevant deadline This field is required.

Examination location (optional)

Deposition date (optional)

Trial date (optional)

Referral source (optional)

Required acknowledgements

I am an attorney, law-firm representative, insurer, claims professional, government representative or other authorized medical-legal professional.

I understand that submitting this form does not create an expert-client, attorney-client or physician-patient relationship, and does not retain Dr. Shomer.

I will not send confidential records or protected health information until conflicts have been checked and secure transfer instructions have been provided.

Verification

Complete the verification below. If it does not appear, JavaScript may be disabled; you may telephone the office at 909-981-9800 instead.

Do not submit medical records, protected health information or confidential documents through this preliminary inquiry form. Secure transfer instructions will be provided after conflict review.

Submitting this form does not retain Dr. Shomer. Retention occurs only through a written agreement after conflict review.

Office

Legal Eye Expert
Marc H. Shomer, MD, PhD, QME
1298 W. 7th Street
Upland, California 91786

Office: 909-981-9800
Fax: 909-946-3937

Services available

Ophthalmology expert-witness consultation — nationwide
California QME evaluations
AME service when selected by the parties
Independent medical examinations — nationwide by arrangement
Medical-record review — nationwide, remote
Deposition and trial testimony — travel by arrangement

Before you write

This website and this form are for attorneys, insurers, claims professionals, government agencies and authorized medical-legal representatives.

This is not a patient-care portal. Dr. Shomer cannot provide medical advice about your own eyes through this form. Patients seeking eye care should contact their own ophthalmologist or, in an emergency, seek immediate medical attention.

What happens after you submit

Conflict screening. The parties and counsel you identify are checked against prior and current engagements.
Response. If no conflict exists, the office will respond with availability, engagement terms, the current fee schedule on request, and secure instructions for transferring records.
Engagement. Retention occurs only through a written agreement. Work begins after that agreement is in place.
Records. Confidential records should be transmitted only through the secure method provided — never through this form or unencrypted email.

Submitting an inquiry does not create an expert-client, attorney-client or physician-patient relationship, does not retain Dr. Shomer, and does not obligate either party to proceed.