Reimbursement Experience Form
Share your feedback on your recent reimbursement experience to help us improve our process.
Overall, how satisfied are you with your reimbursement experience?
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1
2
3
4
5
How easy was it to submit your reimbursement request?
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Very easy
Somewhat easy
Neutral
Somewhat difficult
Very difficult
How clear were the instructions for the reimbursement process?
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Extremely clear
Very clear
Somewhat clear
Not so clear
Not at all clear
Please rate the communication you received during the reimbursement process.
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Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
How quickly was your reimbursement processed?
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Much faster than expected
Faster than expected
As expected
Slower than expected
Much slower than expected
Which aspects of the reimbursement process could be improved? (Select all that apply)
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Instructions clarity
Submission process
Communication
Processing speed
Support/helpfulness
None, everything was good
Other
How fair do you feel the reimbursement outcome was?
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Very fair
Somewhat fair
Neutral
Somewhat unfair
Very unfair
Please rate the helpfulness of the support team (if you contacted them).
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Not helpful
1
2
3
4
Extremely helpful
5
1 is Not helpful, 5 is Extremely helpful
Would you recommend our reimbursement process to others?
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Yes
No
Not sure
Please share any additional comments or suggestions about your reimbursement experience.
Submit Feedback
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