Hooper Holmes, Inc.

Hooper Holmes, Inc., Claims Evaluation Division

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Physician Inquiries

Hooper Evaluations welcomes inquiries from physicians interested in performing medical evaluations as part of our fast-growing, state-wide network of doctors and specialists.

We are committed to the highest professional standards offering the services you require such as accurate, convenient scheduling, phone dictation and more. If you would like more information, please complete the following form and submit it via this web site. One of our associates will provide you with more details on our company and services.

You may also contact:

Hooper Evaluations
170 Mount Airy Road - Basking Ridge, NJ 07920
Tel: (800)554-0347
info@hooperevaluations.com

Important Note: Hooper Evaluations uses the latest technology to protect your information and ensure its security including use of a secure server. Systems are in place to receive your information over secure channels. Furthermore, we will NOT release your information to any outside organization. You can telephone, fax or email your information to us as well. We will NOT provide your name, address, email address, or personal information to any third party.

I am interested in more information about joining Hooper Evaluations as a participating physician.

My specialty is:

Cardiology
Chiropractics
Dental
Dermatology
Endocrinology
Gastroenterology
General Surgery
Infectious Diseases
Internal Medicine
Neurology
Neuropsychology
Neurosurgery
Obstetrics and Gynecology
Ophthalmology

Oral Surgery
Orthopedic Spine
Orthopaedics
Otolaryngology
Pharmaceutical Reviews
Physical Rehabilitative Medicine
Plastic Surgery
Psychiatric/Stress
Pulmonology
Radiology
Urology
Vascular Surgery
Other (Please Specify)

Are you a Board Certified physician?	Yes
	No

Have you performed independent medical evaluations before?	Yes
	No

If yes, for what company or companies?

In what cities or geographic areas of New York State would you like to perform exams? Please detail:

Physician:*
Practice Name:*
Mailing Address:*
City:*	State:* Zip:*
Country:
Phone:*
Fax:
Email Address:*

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Thank you for your interest in Hooper Evaluations.