PSYCHOLOGICAL DOCTOR'S SURVEY

Please Print, fill out and mail to:
Law Enforcement Health Benefit
1237 Spring Garden St
Phila., PA 19123

 

We are currently reviewing services rendered by many professional areas including psychologist, chiropractors, and physical and occupation therapist.  We will eventually have surveys for all medical providers.

We would request that you complete the below questions so LEHB can insure the highest quality service at a reasonable cost. 

 

Doctor’s Name:__________________________________
Company’s Name:________________________________

  Comments:  __________________________________________________________________________________

   _____________________________________________________________________________________________

   _____________________________________________________________________________________________