Conflict Check Request Form

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Thank you for your interest in our availability to assist you. Please complete the following information as throroughly as possible in order to expedite the process of performing a conflict check. A TrialGraphix representative will contact you within 24 hours regarding your request. If you have an urgent need, please contact a workflow coordinator at 800.444.6766.

Note: Fields marked with * are required.

First Name*:

Last Name*:

Your Firm*:

Telephone*:

E-mail*:

Plaintiff(s)*:

separate by commas

Defendant(s)*:

separate by commas

Who do you represent?*

Plaintiff

Defendant

Are the interests of the parties on your side of the case
adverse or potentially adverse?

Yes

Attach Case Caption & Service List Here

Attachment 1:

Attachment 2:

Are there any related cases? If so, please list those case names.

Related Case 1:

Related Case 2:

Related Case 3:

Case Type:

Is this matter
a patent case?

Yes

Patent number(s) and description of device, drug, process, etc.
covered by patent(s):

Without divulging privileged information, what is the case "story"?

Type of Proceeding:

Venue of Proceeding:

Judge Name:

Approximate date of trial:

Service Area Needs: