How to Join

Thank you very much for your interest in Health Law Advocates’ Pro Bono Legal Network. In order to join the Legal Network and accept pro bono case referrals from HLA you must be an attorney in good standing and licensed to practice in Massachusetts. To join, please complete the form below and we will follow up with you.

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Name*
Firm/Organization*
Work - Address Line 1*
Work - Address Line 2
Work - City*
Work - State/Province*
Work - ZIP / Postal Code*
Work - Phone*
Fax
E-Mail Address*
Home - Address Line 1*
Home - Address Line 2
Home - City*
Home - State/Province*
Home - ZIP / Postal Code*
Home Phone*
Type of Practice*	State Federal Administrative Complex litigation Negotiation/ADR Other (please specify below)
Other Practice Type
Practice Area(s)*	Advance Directive/Health Care Proxy Chapter 93A COBRA Community Benefits Disability Law Discrimination EMTALA ERISA Family Law Guardianship Health Law Insurance Law Long-Term Care Medical Malpractice Managed Care Medicaid Medicare Mental Health Mergers/Acquisitions Non-Profit/Charities Law Physician Licensing Privacy Title VI (Civil Rights) Other (please specify below)
Other Practice Area(s)
Year Admitted to Mass. Bar*
Other Bar Admission(s)
Please describe your health law experience (if any).
Approximately how many pro bono hours will you provide per year?*
Other memberships, associations, etc.
Languages spoken
I certify that I am an active member, in good standing, in all jurisdictions where I have been admitted.*	Yes No
If no, please explain.
Please list any legal malpractice or disciplinary complaints filed against you.