Affidavit of Health

STATE OF [Your State], COUNTY OF [Your County]

Introduction

I, [Your Name], of legal age, residing at [Your Address], hereby depose and state as follows:

Statement of Facts

1. I am over the age of 18 and am competent to make this affidavit.

2. I am fully aware of the legal consequences of making this statement under oath, and I solemnly affirm that the following statements are true and correct to the best of my knowledge and belief.

3. I am filing this affidavit in relation to the legal case of [Case Name], currently pending before the [Court Name] in [Your State], wherein I am the victim.

4. On [Date of Incident], I was involved in [Incident] at [Location].

5. As a result of the incident, I sustained injuries to my [Injured Part], which have impacted my health and well-being.

6. The injuries I sustained have caused me significant physical pain, suffering, and emotional distress.

7. I have attached medical records and reports documenting the nature and extent of my injuries, as well as any treatments received.

8. I hereby authorize the use of these medical records and reports as evidence in the legal proceedings mentioned above.

9. I affirm that my health status and the injuries sustained are accurately represented in the attached medical documentation.

10. I make this affidavit in support of my claims in the aforementioned legal case and for no improper purpose.

Sworn Oath

Further, I declare under penalty of perjury under the laws of the State of [Your State] that the foregoing is true and correct.

Executed on this [Date] day of [Month], [Year].

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Sworn to and subscribed before me this [Date] day of [Month], [Year].

[Notary Public Name]

Notary Public, [Your State]

My Commission Expires: [Date]

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