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Injured Employee Network Satisfaction Survey

IMO MED-SELECT NETWORK® INJURED EMPLOYEE SATISFACTION SURVEY

Thank you for your time!

Name (optional)

First
Last
Today's Date
D.O.B.

Date of Birth
Employer / Department
For each question listed below, please select which best represents the most appropriate response based on your experience & involvement with the IMO Certified Network.
1. Overall, I am satisfied with the quality & level of care I've received since my injury.
- Strongly Agree
- Agree
- Not Applicable
- Disagree
- Strongly Disagree
2. My treating doctor gave me a throrough exam, answered my questions & explained my medical condition in a way I understand.
- Strongly Agree
- Agree
- Not Applicable
- Disagree
- Strongly Disagree
3. My treating doctor discussed my medical care & return-to-work program.
- Strongly Agree
- Agree
- Not Applicable
- Disagree
- Strongly Disagree
4. I was able to find a doctor/ specialist who I liked & was able to get the tests & treatments for care in a timely manner.
- Strongly Agree
- Agree
- Not Applicable
- Disagree
- Strongly Disagree
5. I am satisfied with the timeliness relating to my medical care & appointments; my wait to enter the exam room was appropriate.
- Strongly Agree
- Agree
- Not Applicable
- Disagree
- Strongly Disagree
6. I promptly received a call from an IMO Network Case Manager who assisted me in obtaining the services I needed.
- Strongly Agree
- Agree
- Not Applicable
- Disagree
- Strongly Disagree
7. The office staff of the providers' whom I utilized were always courteous & professional.
- Strongly Agree
- Agree
- Not Applicable
- Disagree
- Strongly Disagree
8. My experience was very positive when I worked with the IMO Certified Network team in relation to scheduling appointments & care.
- Strongly Agree
- Agree
- Not Applicable
- Disagree
- Strongly Disagree
9. I found the IMO Med-Select Network® Website helpful & user friendly.
- Strongly Agree
- Agree
- Not Applicable
- Disagree
- Strongly Disagree
10. Overall, I understand the Certified Network & enjoy the benefits that the Network provides.
- Strongly Agree
- Agree
- Not Applicable
- Disagree
- Strongly Disagree
11. At the time of this survey you:
- Have returned to work
- Still off work
- Working light or modified duty
Please provide any additional feedback which may be utilized to improve our services in the space provided below. We appreciate your efforts & participation in the IMO Med-Select Network®:

Network Satisfaction Surveys

Injured Employee Network Satisfaction Survey
Provider Network Satisfaction Survey
TPA/Carrier Network Satisfaction Survey

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