Instructions

Thank you for taking the time to provide feedback regarding your recent medical disability examination. Your feedback is very important in assessing the level of care provided by the medical disability examination contractors. All feedback is provided to the VA for further review. 
 
Please use the survey card provided to you to fill out the identifying information in the survey, i.e. Doctor's Name, Appointment Date, State of Appointment, MDE Contractor, and Survey Card Number. Please note that some questions/fields are mandatory. When you have completed the survey, please click the “Done” button and do not mail the paper version. Please see the sample picture below for additional assistance. PLEASE NOTE: The sample picture below is not your survey. The survey card provided as part of your appointment is the survey to be used. 
 
If you did not receive a survey card please refer to the email or letter you received which will include the necessary information needed to fill out the survey.

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