Become a Member of ALL MD

Home • Association of Liability Lawyers in Medical Defense • Become a Member of ALL MD

Are you interested in joining ALL MD? Fill out the form below and we’ll start the approval process. The process is rigorous, but this helps ensure we put the top healthcare defense attorneys in front of our thousands of physician and healthcare clients.

Please fill out as much information as possible. This will help give your profile more visibility to our physician and healthcare professional clients. Under “Categories,” please select all states you are licensed to practice in.

Healthcare Defense Lawyer Info

PrefixFirst NameMiddle NameLast NameSuffix

Title

Name of Firm

Department

Contact First NameContact Last Name

States Where you Practice

Image

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Logo

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Addresses

<div class="widget-title">
				<h4>
					<span class="address-type">
					<label for="cn-address[::FIELD::][type]" >Address Type</label><select id="cn-address[::FIELD::][type]" name="address[::FIELD::][type]" ><option value="home" selected='selected'>Home</option><option value="work" >Work</option><option value="school" >School</option><option value="other" >Other</option></select>
<span class="preferred"><span class="cn-radio-group">
	<span class="cn-radio-option"><input type="radio" id="cn-address[preferred][::FIELD::]" name="address[preferred]" value="::FIELD::" /><label for="cn-address[preferred][::FIELD::]" >Preferred</label></span>
</span></span>
					</span>
					
				</h4>
			</div>

</div>

<div class="address-line"><label for="cn-address[::FIELD::][line_1]" >Address Line 1</label><input type="text" id="cn-address[::FIELD::][line_1]" name="address[::FIELD::][line_1]" value="" /></div><div class="address-line"><label for="cn-address[::FIELD::][line_2]" >Address Line 2</label><input type="text" id="cn-address[::FIELD::][line_2]" name="address[::FIELD::][line_2]" value="" /></div><div class="address-line"><label for="cn-address[::FIELD::][line_3]" >Address Line 3</label><input type="text" id="cn-address[::FIELD::][line_3]" name="address[::FIELD::][line_3]" value="" /></div><div class="address-line"><label for="cn-address[::FIELD::][line_4]" >Address Line 4</label><input type="text" id="cn-address[::FIELD::][line_4]" name="address[::FIELD::][line_4]" value="" /></div>
			</div>

<div class="address-district"><label for="cn-address[::FIELD::][district]" >District</label><input type="text" id="cn-address[::FIELD::][district]" name="address[::FIELD::][district]" value="" /></div><div class="address-county"><label for="cn-address[::FIELD::][county]" >County</label><input type="text" id="cn-address[::FIELD::][county]" name="address[::FIELD::][county]" value="" /></div>
			</div>

<div class="address-city"><label for="cn-address[::FIELD::][city]" >City</label><input type="text" id="cn-address[::FIELD::][city]" name="address[::FIELD::][city]" value="" /></div><div class="address-state"><label for="cn-address[::FIELD::][state]" >State</label><input type="text" id="cn-address[::FIELD::][state]" name="address[::FIELD::][state]" value="" /></div><div class="address-zipcode"><label for="cn-address[::FIELD::][zipcode]" >Zipcode</label><input type="text" id="cn-address[::FIELD::][zipcode]" name="address[::FIELD::][zipcode]" value="" /></div>
			</div>

<div class="address-country"><label for="cn-address[::FIELD::][country]" >Country</label><input type="text" id="cn-address[::FIELD::][country]" name="address[::FIELD::][country]" value="" /></div>
			<div class="address-geo">

<div class="address-latitude"><label for="cn-address[::FIELD::][latitude]" >Latitude</label><input type="text" id="cn-address[::FIELD::][latitude]" name="address[::FIELD::][latitude]" value="" /></div><div class="address-longitude"><label for="cn-address[::FIELD::][longitude]" >Longitude</label><input type="text" id="cn-address[::FIELD::][longitude]" name="address[::FIELD::][longitude]" value="" /></div>
				
			</div>

<p class="cn-remove-button">
				<a href="#" class="cn-remove cn-button button cn-button-warning"
				   data-type="address"
				   data-token="::FIELD::">Remove</a>
			</p>
			
		</div>

Add Address

Phone Numbers

<label for="cn-phone[::FIELD::][type]" >Phone Type</label><select id="cn-phone[::FIELD::][type]" name="phone[::FIELD::][type]" ><option value="homephone" selected='selected'>Home Phone</option><option value="homefax" >Home Fax</option><option value="cellphone" >Cell Phone</option><option value="workphone" >Work Phone</option><option value="workfax" >Work Fax</option></select>
<span class="preferred"><span class="cn-radio-group">
	<span class="cn-radio-option"><input type="radio" id="cn-phone[preferred][::FIELD::]" name="phone[preferred]" value="::FIELD::" /><label for="cn-phone[preferred][::FIELD::]" >Preferred</label></span>
</span></span>

</h4>
			</div>

</div>

<label for="cn-phone[::FIELD::][number]" >Phone Number</label><input type="text" id="cn-phone[::FIELD::][number]" name="phone[::FIELD::][number]" value="" />
			</div>

<p class="cn-remove-button">
				<a href="#" class="cn-remove cn-button button cn-button-warning"
				   data-type="phone"
				   data-token="::FIELD::">Remove</a>
			</p>
			
		</div>

Add Phone Number

Email Addresses

<label for="cn-email[::FIELD::][type]" >Email Type</label><select id="cn-email[::FIELD::][type]" name="email[::FIELD::][type]" ><option value="personal" selected='selected'>Personal Email</option><option value="work" >Work Email</option></select>
<span class="preferred"><span class="cn-radio-group">
	<span class="cn-radio-option"><input type="radio" id="cn-email[preferred][::FIELD::]" name="email[preferred]" value="::FIELD::" /><label for="cn-email[preferred][::FIELD::]" >Preferred</label></span>
</span></span>

</h4>
			</div>

</div>

<label for="cn-email[::FIELD::][address]" >Email Address</label><input type="text" id="cn-email[::FIELD::][address]" name="email[::FIELD::][address]" value="" />
			</div>

<p class="cn-remove-button">
				<a href="#" class="cn-remove cn-button button cn-button-warning"
				   data-type="email"
				   data-token="::FIELD::">Remove</a>
			</p>
			
		</div>

Add Email Address

Links

<label for="cn-link[::FIELD::][type]" >Type</label><select id="cn-link[::FIELD::][type]" name="link[::FIELD::][type]" ><option value="website" selected='selected'>Website</option><option value="blog" >Blog</option></select>
<span class="preferred"><span class="cn-radio-group">
	<span class="cn-radio-option"><input type="radio" id="cn-link[preferred][::FIELD::]" name="link[preferred]" value="::FIELD::" /><label for="cn-link[preferred][::FIELD::]" >Preferred</label></span>
</span></span>

</h4>
			</div>

</div>

<label for="cn-link[::FIELD::][title]" >Title</label><input type="text" id="cn-link[::FIELD::][title]" name="link[::FIELD::][title]" value="" />
			</div>

<span class="target"><label for="cn-link[::FIELD::][target]" >Target</label><select id="cn-link[::FIELD::][target]" name="link[::FIELD::][target]" ><option value="new" selected='selected'>New Window</option><option value="same" >Same Window</option></select></span>
<span class="follow"><select id="cn-link[::FIELD::][follow]" name="link[::FIELD::][follow]" ><option value="nofollow" selected='selected'>nofollow</option><option value="dofollow" >dofollow</option></select></span>

</div>

<label>
					<input type="radio" name="link[image]" value="::FIELD::" >
					Assign link to the image.				</label>
				<label>
					<input type="radio" name="link[logo]" value="::FIELD::" >
					Assign link to the logo.				</label>

</div>
			
			
						<p class="cn-remove-button">
				<a href="#" class="cn-remove cn-button button cn-button-warning"
				   data-type="link"
				   data-token="::FIELD::">Remove</a>
			</p>
			
		</div>

Add Link

Dates

<label for="cn-date[::FIELD::][type]" >Type</label><select id="cn-date[::FIELD::][type]" name="date[::FIELD::][type]" ><option value="anniversary" >Anniversary</option><option value="baptism" >Baptism</option><option value="birthday" >Birthday</option><option value="deceased" >Deceased</option><option value="certification" >Certification</option><option value="employment" >Employment</option><option value="membership" >Membership</option><option value="graduate_high_school" >Graduate High School</option><option value="graduate_college" >Graduate College</option><option value="ordination" >Ordination</option></select>
<span class="preferred"><span class="cn-radio-group">
	<span class="cn-radio-option"><input type="radio" id="cn-date[preferred][::FIELD::]" name="date[preferred]" value="::FIELD::" /><label for="cn-date[preferred][::FIELD::]" >Preferred</label></span>
</span></span>

</h4>
			</div>

</div>

<label for="cn-date[::FIELD::][date]" >Date</label><input type="text" class="cn-datepicker" id="cn-date[::FIELD::][date]" name="date[::FIELD::][date]" value="" />
			
			<p class="cn-remove-button">
				<a href="#" class="cn-remove cn-button button cn-button-warning"
				   data-type="date"
				   data-token="::FIELD::">Remove</a>
			</p>

</div>

Add Date