Doctors of Defense Survey
InvestigateTV is seeking to continue our reporting on medical malpractice in the military health care system. We are seeking personal stories of service members and their families who experienced malpractice as well as those who have filed claims or lawsuits against the government (non-battlefield related)
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Email *
Who was affected by the medical malpractice or mistake? *
Branch of Service *
Currently serving? *
Type of injury *
Was it fatal?  *
Date of Occurrence *
MM
/
DD
/
YYYY
Description of how injury/death occurred (surgery, misdiagnosis, missed diagnosis, etc)
 *
Military base/hospital where injury/death occurred
 *
Names of physicians involved in injury/death, if known. (In unknown, write “unknown”)
 *
Filed claim or lawsuit?
 *
Is the case active?
Clear selection
If the case is resolved, did you receive compensation from the government?
Clear selection
Your name (will not be reported until contacted first)
 *
Your email (will not be shared publicly)
 *
Your phone number (will not be shared publicly)
 *
Would you consider being interviewed?
 *
Submit
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