We're always working to improve service to our providers! Help us by filling out this brief survey.

Please indicate your area of medicine. (Mark all that apply)

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* 1. Please indicate your area of medicine. (Mark all that apply)

Please mark who is completing this survey. (Mark only one)

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* 2. Please mark who is completing this survey. (Mark only one)

If you have an NPI, please share:

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* 3. If you have an NPI, please share:

What is the name of your medical group:

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* 4. What is the name of your medical group:

What is your preferred method of receiving communications from this health plan?

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* 5. What is your preferred method of receiving communications from this health plan?

Do you have a Provider Relations representative from this health plan assigned to your practice?

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* 6. Do you have a Provider Relations representative from this health plan assigned to your practice?

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