__[Attorney name]__
__[Address]__
__[Telephone number]__
Attorney for Plaintiff, __[name]__
_ _ _ _ _ _ Court, County of _ _ _ _ _ _
__[_ _ _ _ _ _ District]__
_ _ _ _ _ _ _ _ _ _ _ _ _ ) No. _ _ _ _ _ _
Plaintiff(s))
vs. )CERTIFICATE OF RELIANCE ON
)__[RES IPSA LOQUITUR]__ __[AND
_ _ _ _ _ _ _ _ _ _ _ _ _ ) ON]__ __[FAILURE TO INFORM]__ Defendant(s))(CCP 411.35(d))
_________________________ )
__[Name]__ declares:
1. I am the attorney for plaintiff, __[name]__, in this
action.
2. This action is one for damages arising out of
professional negligence.
3. A certificate of merit is not required because
plaintiff intends to rely solely on __[the doctrine of res ipsa
loquitur]__ __[and on]__ __[defendant __[name]__'s failure to
inform plaintiff of the consequences of a procedure]__.
I certify under penalty of perjury under the laws of the
State of California that the foregoing is true and correct.
Date: _ _ _ _ _ _ [Signature]
_________________________
__[Typed name]__
Attorney for _ _ _ _ _ _ _ _ _
Return to Table of Contents for
Legal Forms : Set Two