I hereby certify that I am an appropriate health care provider qualified to render an affidavit of merit in this medical malpractice case as specified by Utah Code Subsection 78B-3-423(4). My license class and professional specialty are: (describe). |
I further certify that I have reviewed the medical records and other relevant material involved in this medical malpractice case and have determined that: |
(1) In my opinion, there are reasonable grounds to believe that the applicable standard of care was breached by the following respondent(s): (identify by name each respondent included in the affidavit). |
(2) In my opinion, the breach was a proximate cause of the injury claimed in the notice of intent to commence action. |
(3) The specific reasons for my opinion are (explanation for each respondent named in the affidavit). |
Utah Admin. Code R156-78B-16c