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1. Title and Court Details: Specifies the court jurisdiction, case number if applicable, and title of the affidavit
2. Deponent Information: Full name, professional qualifications, registration number, current position, and place of practice of the medical professional making the affidavit
3. Basis of Knowledge: Statement explaining the deponent's involvement in the case and the source of their knowledge
4. Patient Information: Details of the patient including full name, identification number, and relevant demographic information
5. Medical Facts: Chronological presentation of relevant medical facts, treatments, procedures, and observations
6. Professional Opinion: Medical opinions and conclusions based on the stated facts and professional expertise
7. Declaration of Truth: Formal statement declaring that the contents are true to the best of the deponent's knowledge
8. Execution Block: Space for signature, date, and commissioner for oaths' attestation
1. Reference to Prior Medical Records: Section citing and summarizing previous medical records when the affidavit relates to historical medical events
2. Third Party Observations: Including observations or reports from other medical professionals when multiple healthcare providers were involved
3. Capacity Assessment: Specific section addressing the patient's mental capacity when relevant to legal proceedings
4. Treatment Recommendations: Future medical recommendations when the affidavit is used for treatment planning or court orders
5. Cost of Care: Detailed breakdown of medical costs when the affidavit is used in insurance or compensation claims
1. Medical Records: Copies of relevant medical records, test results, and clinical notes
2. Diagnostic Images: Relevant X-rays, MRI scans, or other medical imaging with annotations
3. Laboratory Reports: Copies of laboratory test results referenced in the affidavit
4. Professional Credentials: Copies of relevant professional qualifications and certifications
5. Medical Literature: Relevant medical research or literature supporting professional opinions expressed in the affidavit
6. Photographic Evidence: Photographs of injuries, conditions, or medical procedures when relevant
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