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Any Attorney or Party

Any Street
Any Town, CA 55555

714-555-5555

Any Attorney or Party

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Superior Court of the State of California

For the County of _________________

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Any Plaintiff,

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Plaintiff,
vs.
Any Defendant, and DOES 1-5

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Defendants.

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Case No.
DEMAND FOR PHYSICAL EXAMINATION
TRIAL DATE:
TIME:
DEPT:
DISCOVERY CUT-OFF DATE:

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by LegalDocsPro visit http://legaldocspro.net/
Be sure to remove this notice and all other notices before

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using this document. Modify the wording as appropriate.

- 1 DEMAND FOR PHYSICAL EXAMINATION

TO PLAINTIFF NAME OF PLAINTIFF AND THEIR ATTORNEY OF RECORD:

PLEASE TAKE NOTICE THAT Defendant, NAME OF DEFENDANT (PROPOUNDING

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PARTY) hereby demands, pursuant to the provisions of Code of Civil Procedure 2032.220, that
Plaintiff, NAME OF PLAINTIFF (Plaintiff) submit to a physical examination by Dr. NAME OF
DOCTOR (DOCTOR), whose specialty is LIST SPECIALTY OF DOCTOR at the following

date, time and place:

DATE: LIST DATE OF EXAMINATION

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TIME: LIST TIME OF EXAMINATION

PLACE: LIST NAME AND ADRESS WHERE THE EXAMINATION WILL TAKE PLACE
and continuing so long as reasonably required. The DOCTORS examination of Plaintiff will

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consist of a general physical examination, including Plaintiff completing a medical questionnaire and

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submitting to an interview, blood samples for laboratory analysis, and LIST ANY OTHER TESTS

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TO BE PEFORMED. The scope of the examination will be

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(a) to ascertain whether Plaintiff has been MODIFY THE FOLLOWING EXAMPLE TO

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SUIT YOUR PARTICULAR SITUATION rendered sick, sore, lame, disabled and disordered,

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both internally and externally, and suffered, among other things, numerous internal injuries, severe

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fright, shock, pain, discomfort and anxiety, as alleged in Plaintiffs Complaint 24, 38, 49, 53 and

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57, and

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(b) to ascertain whether Plaintiff suffers from any asthma-related condition, such as

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preasthma,, and
(c) to ascertain the severity any such condition, including whether any such
condition is permanent or incurable.

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- 2 DEMAND FOR PHYSICAL EXAMINATION

PROPOUNDING PARTY is entitled to obtain the physical examination without

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leave of the court because Plaintiff has alleged physical injuries, as quoted above, and also
because Plaintiff has prayed For medical expenses and related items of expense, according
to proof, as alleged in Plaintiffs Complaint at page __, line __.
PLEASE TAKE FURTHER NOTICE THAT pursuant to the provisions of Code of Civil

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Procedure 2032.230(b), Plaintiff is required to serve a response on PROPOUNDING PARTY

within 20 days of the service hereof (25 days if served by mail.)

Modify the wording as appropriate.

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Dated________________

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_______________________________________________
ANY ATTORNEY OR PARTY

Remember that the examination cannot include any diagnostic

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test or procedure that is painful, protracted or intrusive and the

examination must be conducted at a location within 75 miles of the
residence of the examinee. See Code of Civil Procedure 2032.220(a)(1)

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(2).

You must schedule the examination for a date that is least 30 days

after the demand is served, (35) days if served by mail, see Code of Civil

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Procedure 2032.220(d) and must serve a copy of this demand on the

plaintiff and all other parties that have appeared in the action. See
Code of Civil Procedure 2032.220(e).

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- 3 DEMAND FOR PHYSICAL EXAMINATION

PROOF OF SERVICE

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I am over the age of 18 and not a party to this action.

I am a resident of or employed in the county where the mailing occurred; my
business/residence address is: ADDRESS OF PERSON SERVING PAPERS.
On ____________________ I served the foregoing document(s) described as: DEMAND
FOR PHYSICAL EXAMINATION to the following parties:
NAME AND ADDRESS OF ATTORNEY FOR OTHER PARTY OR OTHER PARTY
WITHOUT AN ATTORNEY
[X] (By U.S. Mail) I deposited such envelope in the mail at ______________,
California with postage thereon fully prepaid. I am aware that on motion of the
party served, service is presumed invalid if postal cancellation date or postage
meter date is more than one day after date of deposit for mailing in affidavit.
[ ] (By Personal Service) I caused such envelope to be delivered by hand via
messenger service to the address above;
[ ] (By Facsimile) I served a true and correct copy by facsimile during regular
business hours to the number(s) listed above. Said transmission was reported
complete and without error.
I declare under penalty of perjury under the laws of the State of California that the foregoing
is true and correct.

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DATED: ______________
_______________________________________
NAME OF PERSON SERVING PAPERS

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- 4 DEMAND FOR PHYSICAL EXAMINATION