Our customer is our most important priority.

 We are committed to providing each patient the quality of care and comfort we want for our families and for ourselves. Please take a moment to give us your feedback on the services and care provided by IMA. Your opinions will be used in ongoing improvement efforts and your individual responses will be kept confidential.

* 1. Name:

* 2. Phone:

* 3. Email Address:

* 4. Company:

* 5. Please enter your preferred method of communication:

* 6. How many employees do you have?

Please indicate your level of satisfaction:

* 13. What do you consider to be an acceptable wait time for occupational services?

* 14. Which occupational services are currently used by your company? (Please check all that apply)

* 15. What current on-site programs do you utilize? (Please check all that apply)

Overall Satisfaction

* 20. How likely is it that you would recommend IMA to a friend or colleague?

Not at all likely
Extremely likely

* 22. What occupational service are you using that IMA currently does not provide?

* 23. Any comments you'd like to share? If you would like to be contacted, please provide your contact information above.

* 24. Please Rate the Following:

  Excellent Very Good Good Poor Very Poor N/A
Location of Facility
Parking
Hours of Operation
Employees Time at Clinic
Wait Time to See Provider/Physician
Courtesy and Professionalism of Clinic Staff
Courtesy and Professionalism of Physician/Provider
Account Executive Responsiveness/Professionalism
Overall Satisfaction With IMA Services

* 25. Please Rate the Following:

  Excellent Very Good Good Poor Very Poor N/A
Do the invoices or HCFA's provide sufficient information and a clear explanation of servicer rendered?
Was the billing staff knowledgeable to offer a clear explanation of your questions, concerns or billing issues in a timely manner?
Overall satisfaction of billing services?

* 26. In your opinion, are there areas where the Billing Department can improve?

T