Mark Kremen MD
10824 Old Mill Rd. #21, Omaha, NE 68154
Ph: 402-330-6060, Fax: 402-330-6108
Certified by the American Board (ABPN) of Psychiatry and Neurology
Sub-Specialty Board Certification in Forensic Psychiatry, Geriatric Psychiatry, and Addiction Psychiatry
Fellow, Royal Australian and New Zealand College of Psychiatrists (FRANZCP)
Retaining Attorney: ______________________________________________________________________________________
Law Firm Address: _______________________________________________________________________________________
Phone: ______________________________________ Fax: ____________________________________
Web Page:____________________________________ Email: __________________________________
Phone:______________________________________ Fax: ____________________________________
Web Page:___________________________________ Email:___________________________________
Referral Question or Concern: _______________________________________________________________________________
Thank you for referring your questions regarding the above named case to me for forensic psychiatric evaluation. I am pleased to provide professional services regarding this case upon receipt of an executed copy of this Expert Witness Retainer Agreement in addition to the agreed upon retainer fee of $4000.
The role of an Expert witness is to develop the best possible unbiased understanding and opinion related to the Question or Concern being asked about. It is not to provide clinical treatment.
In being retained as an Expert Witness it is understood that no specific opinion or finding is in any way assured or guaranteed.
No work will be completed on a contingency basis. Disagreement over specific findings in no way absolves the undersigned of payment for services provided.
My billing rate is $400 per hour. I bill my rate in quarter-hour increments for all time devoted to the case, including phone calls, consultations, research and preparing reports, as needed. I will refund any unused portion from the retainer fee once it is clear that my services will no longer be required. However, my minimum charge for agreeing to be retained as an expert or consultant in this case is 4 hours of my time, or $1,600.
In the event that work in the case exceeds the initial retainer fee, no report will be released nor testimony scheduled (in court or by deposition) until the entire balance is paid. Testimony in court or by deposition is billed in half-day (4-hour) blocks or whole day blocks (8 hours). Payment for my time involved in such testimony must be pre-paid. In the event there are travel expenses, these must be paid by the retaining attorney. Fees for travel-time may vary but I will provide a good-faith estimate depending on the situation. If an examinee fails to show up for the evaluation, I still must charge for the time I had blocked out for the case. A rescheduled date and time can be arranged. If the attorney decides not to reschedule, the minimum charge for the 4-hour block of time will still apply.
I strongly recommend that the retaining attorney forward for my review all relevant medical records, mental health records, investigation reports, witness statements, school records, job descriptions and employment records, legal records, military records, depositions and any other case information prior to my examination of the subject to be evaluated. I recommend these materials be sent as far in advance of my scheduled examination of the examinee as possible so that I might be as efficient as possible in evaluating the case. I would prefer that records be sent at least two weeks in advance.
If other professional services, such as an evaluation or testing by a Psychologist, seem warranted, arrangements for this would be discussed before any arrangements were made. If there has been prior Psychological testing, the raw data should be requested for a second opinion by another qualified Psychologist.
Once it is decided that I will no longer be involved in the case, either because the case has been resolved or my services are no longer required by the retaining attorney, and I have been notified of this in writing, I will return all records to the retaining attorney. There may be a charge for large volumes of materials returned, to cover excessive postage.
By signing below, the retaining attorney indicates acceptance of this service agreement and the contractual provisions contained herein. Please return this form along with the agreed-upon retainer fee noted above. In return, I will countersign and send a completed contract back to the retaining attorney. If this signed service contract and retainer are not received within 10 business days of our initial communication about the case, then my name shall not be listed by the retaining attorney or retaining firm as a witness and I will be free to be retained by other parties, including opposing counsel.
Upon being retained by an attorney, company or firm, I am retained for that specific case only and may be retained by any other attorney, including opposing counsel, for other cases so long as there is not a direct conflict-of-interest.
Contract accepted by:
_____________________ Date: ____ Mark Kremen MD Date: ______
_____________________ Date: _____ _______________ Date: ______