Forms

Confirmation of Fees and Retainer Agreement

1.1 Please enter your information

Date

Name

First Last

Law Office

Case Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone

1.2 Retainer Fee

Billing Period

Total Amount

Delivery date

2. Retainer Agreement

Re: Legal Nurse Consulting Services with Valtrus Nurse Consulting

Dear Attorney [insert name],

Based on our conversation and subsequent agreement on [Agreement Date] this letter confirms that Valtrus Nurse Consulting’s fee for [Case Name] is estimated at [$Fee] to be submitted no later than [Delivery Date].

Valtrus Nurse Consulting will submit invoicing to [insert email] via email invoice, and payment is due within 7 days of receipt. Both check and credit card payments are accepted.

A retainer fee in the amount of [insert amount] must be received before work will begin on this case.
It is our intention that services shall be rendered as an “independent contractor” and we agree that this letter agreement does not create an employee/employer relationship, nor does it form a partnership between us.

Upon your receipt of this letter, please acknowledge your agreement to the terms specified above by signing below.
I look forward to working with you.

If you have any questions or need to contact me, please do so at (562) 825-8787.

Warmest regards,
Valtrus Nurse Consulting
Reeva C. Van Brunt, MSN, PHN, CNL, PCCN, RN
Legal Nurse Consultant
Tel: (562) 825-8787
Email:
Website: valtrusnc.com

Please make all future payments to:
Valtrus Nurse Consulting
12263 La Mirada Blvd. #448
La Mirada, CA 90638
EIN: 87-2916607

Agreed and accepted:

[insert Name]
[insert title]
[insert date]

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