IME & Impairment Rating Request: Intake Form

CBCLogic IME and Impairment Rating

Downloadable Files:

Below are downloadable versions of our various protocols. Please download and review before scheduling any IME or IR.

IME Physician Protocol-
Park Ridge
 PDF

IME Physician Protocol-
Champaign
 PDF

Here you will find a detailed explanation and various requirements for a scheduled IME appointment. Please download and review before scheduling any IME.

IME Pre-Pay Charges Protocol PDF

Here you will find a detailed and itemized explanation of our pre-pay IME charges. Please download and review before scheduling any IME.

IME Charges Protocol PDF

Here you will find a detailed and itemized explanation of our pre-pay IME charges. Please download and review before scheduling any IME.

IME Imaging Charges Protocol PDF

Here you will find a detailed and itemized explanation of our IME imaging charges. Please download and review before scheduling any IME.

Impairment Rating Protocol-
Park Ridge
 PDF

Impairment Rating Protocol-
Champaign
 PDF

Here you will find a detailed explanation and various requirements for a scheduled Impairment Rating appointment. Please download and review before scheduling any Impairment Rating.

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Workers’ Compensation Coordinator