Policies & Feedback

Policies that protect your rights and the means to provide feedback.

Policies

Accessibility Policy
Code of Conduct and Ethics Policy
Complaints and Appeals Policy
Observers and Recording Policy
Privacy Policy
Rights of Persons Served

Feedback Forms

Claimant / Examinee Satisfaction Survey
Referral Source Satisfaction Survey
Examiner Satisfaction Survey

Claimant / Examinee Satisfaction Survey

Thank you for taking the time to provide us with your feedback.

    Please fill out all fields for a complete submission. We thank you for taking the time to provide us with your feedback.

    Your Name:

    Your Email Address:

    Date of your examination (YYYY-MM-DD):

    Ability of examiner to explain nature and purpose of the examination?

    Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

    Scheduling of examination on time?

    Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

    Cleanliness of office and examination room?

    Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

    Professionalism and courtesy of our staff?

    Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

    Professionalism and courtesy of our examiner(s)?

    Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

    Satisfaction with arrangement of auxiliary services (e.g., Transportation, Translation, etc.)?

    Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

    Overall, how satisfied were you with your interaction(s) with Benchmark IME?

    Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

    Any comments/feedback/questions you may have:

    Referral Source Satisfaction Survey

    Thank you for taking the time to provide us with your feedback.

      Please fill out all fields for a complete submission. We thank you for taking the time to provide us with your feedback.

      Your Name:

      Your Email Address:

      How satisfied are you with...

      our referral process?

      Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

      how quickly we responded with an assessment?

      Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

      how soon we could book an assessment?

      Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

      how quickly we delivered your report?

      Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

      the method of report delivery?

      Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

      the quality of our reports?

      Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

      our customer service?

      Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

      the Information Technology used to support and deliver our services?

      Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

      Benchmark IME overall?

      Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

      Any comments/feedback/questions you may have:

      Examiner Satisfaction Survey

      Thank you for taking the time to provide us with your feedback.

        Please fill out all fields for a complete submission. We thank you for taking the time to provide us with your feedback.

        Your Name:

        Your Email Address:

        Your professional discipline/specialization:

        How satisfied are you with...

        Ability of Benchmark IME to assign referral(s) and arrange services?

        Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

        Ability of Benchmark IME to provide clear instructions?

        Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

        Method of documentation delivery?

        Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

        Timeliness of documentation delivery?

        Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

        Quality control measures?

        Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

        Ability of Benchmark IME to provide payment in a timely manner?

        Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

        Professionalism and courtesy of our staff?

        Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

        Use of Information Technology pertaining to the delivery of our products and services?

        Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

        Overall satisfaction with Benchmark IME?

        Very SatisfiedSatisfiedSomewhat SatisfiedSomewhat DissatisfiedDissatisfiedVery Dissatisfied

        Any comments/feedback/questions you may have:

        Schedule a Meeting

        Call us directly at 1.888.293.3601 to schedule a meeting or fill out the form below.

        A Benchmark IME Coordinator will get in touch with you within 1 to 2 business days to setup an ideal time to give you a demonstration of our system, answer any questions you may have and get you started on a new path to managing your IME's.


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          Submit a Referral

          Referrals can be made in the following manner:

          Phone: 905.827.4248
          Toll Free: 1.888.293.3601
          Fax: 905.827.6085
          Email: referrals@benchmarkime.com