In addition to submitting an agreement to arbitrate, a party alleging malpractice must submit a check or money order made out to the Court Administrator in the amount of $100.00. Finally, a claimant must submit the claim to the Court Administrator by means of "Court Administrator Form No. 3." Form 3 requires the following:
(a) Names, ages, and addresses of all plaintiffs and the names and addresses of their attorneys; (b) Names, addresses, and nature of employment of all respondents and the names and addresses of their attorneys; (c) Statement of the claim including the time of occurrence, the place, the circumstances, the alleged negligent act or omission, the injury or damages sustained, the relief demanded, and the date upon which the claimant became aware of the nature and existence of the claim; (d) Statement that no trial has ever commenced as to the claim asserted. Vt. Med. Mal. Arbit. R. 3
Adopted Dec. 2, 1976; amended June 27, 1990, eff. 7/1/1990.