In accordance with section 10.14 of the MCA Code of Practice, you as a Decision Maker are required to give feedback about how the IMCA worked with you on each case as well as explaining if the outcome was significantly affected by the involvement of an IMCA. Completing the simple online form below will enable us to ensure we are meeting these requirements.

If you would like to give additional feedback about POhWER you can do this by clicking on the stakeholder feedback tab and fill out the simple online feedback form.

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1. Client Name (Required.)

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2. Decision Maker (Required.)

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3. Name of IMCA (Required.)

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4. Issue for decision (Required.)

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5. What is the proposed decision following the IMCA report and what are the time scales to implement this? (Required.)

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6. How have you taken the points for consideration from the IMCA report into account in your decision? If there are any points that you have not used in your decision, please explain why. (Required.)

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7. How well do you think you worked with the IMCA on this case? (Required.)

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8. Please use this box to tell us more about how well you think you worked with the IMCA on this case (Required.)

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9. How well do you think the IMCA worked with you on this case?

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10. Please use this box to tell us more about how well you think the IMCA worked with you on this case

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11. Was the outcome significantly affected by the involvement of the IMCA? (Required.)

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12. Please use this box to tell us more about how the outcome was significantly affected by the involvement of the IMCA (Required.)

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13. Date the decision was made (Required.)

Date

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14. Are you completing this form on behalf of someone else? (Required.)

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15. Enter the Contract Code if known:

T