Thank you allowing AMC Case Managers to assist with your work injury.  We value your input as a measure of our company’s effectiveness and ask that you take a few moments to complete the following questionnaire to enable us to better serve injured workers similar to yourself.

* 1. Timeliness of case manager contact:

* 2. Case Manager explanation of CM services:

* 3. Availability and accessibility of case manager by phone, email or text:

* 4. Case managers assistance in explaining the injury, treatment and medications:

* 5. Effectiveness of the case manager in resolution of injury:

* 6. Rate your involvement in decision making pertaining to your injury:

* 7. Were you satisfied with the outcome of your case management services?

* 8. Additional Comments

* 9. Case Manager Name