Claimant / Examinee Satisfaction Survey





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:

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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.


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