IME Provider Training Online Evaluation & Suggestions

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Contact Information

Name: *

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Business Address

Street Address

Address continued

City

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Phone #:

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Organization / Company Name *

E-mail Address: *

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Provider Type *

Vision, Dental, Nursing Home, etc. (required)

NPI

(Not Required but highly Recommended)

Comments and Suggestions

Any technical flaw found in websites, or other technical difficulties? *

The IME is interested in improving the training sessions. Please share your thoughts, questions, and indicate any topics that you would like to have detailed in future presentations.

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