Medical Record Review Intake Form
Thank you for your interest in the Keck Human Rights Clinic Medical Record Review Service. This service addresses cases that involve human rights violations in the carceral, pre-carceral, or otherwise justice-involved settings, and in cases of harm incurred during advocacy or protest. This service connects volunteer licensed physicians with attorneys representing these clients to provide pro bono medical record review where the client's health has been impacted by law enforcement actions, with priority given to pro bono and low bono cases. Please keep in mind that our providers are consultants only - our service does not replace, provide, or refer expert witnesses. We can provide you with advice, explain information that can be gained from reading the medical records, and help shape your understanding of the records, medical issues, causation and damages early in the case.

Please be advised we ask for a minimum of one month from the time of form submission to assign a volunteer provider and allow them sufficient time to review the necessary records. We will make every effort to connect you with a provider, but, unfortunately we cannot guarantee each case will be placed. We appreciate your understanding as we continue to improve this program.

Please contact contact@keckhumanrights.com with any additional questions you may have.
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