To Plaintiff, __________ [name], and _____ [his or her or its]
attorney:
Defendant, __________ [name], demands that plaintiff appear
on __________ [date at least 30 days after service of demand],
at __________ [time], at __________ [address], __________
[city], __________ County, California, for a routine physical
examination by __________ [name of examining physician or as the
case may be], who is __________ [title or other qualifications,
such as: a licensed orthopedic specialist].
The physical examination of plaintiff, which does not
involve any diagnostic test or procedures that are painful,
protracted, or intrusive, will be conducted in order to
__________ [describe nature and scope of examination, such as:
determine the nature and extent of the personal injuries claimed
in plaintiff's complaint]. The examination will be conducted as
follows: __________ [describe manner, conditions, and scope of
examination].
