Place Listing

REACH OVER 30,000 KEY IME REFERRAL SOURCES NATIONWIDE

To become listed in the next edition of the SEAK National Directory of Independent Medical Examiners™; please complete the following form. The Directory will be sent to over 30,000 key IME decision makers nationwide, and you will also be listed on the Directory's website.

Referrals are GUARANTEED. If at any time within 8-months after the publication of the first Directory in which you appear, you are not completely satisfied, you may request and receive a full refund of your standard listing fee.

If you have any questions please contact Alex Babitsky at (508)457-5150 or via email at alex@seak.com
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Please select a listing type *

Standard Listings

Next Annual Directory $495
Next 2 Annual Directories $895
Next 3 Annual Directories $1,195

Expanded Listings
Register for any Expanded Listing and get a 1-year standard listing FREE

Half-Page $995
(7.5 " x 5 ") black & white

Full-Page $1,495
(7.5 " x 10 ") black & white

Standard Listing Information

First Name:*
Middle Initial:
Last Name:*
Degree:
Organization:
Street Address 1:*
Street Address 2:
City:*
State:*
Zip:*
Additional IME Locations:
(city and state only please)

Phone:*
Fax:
Email:
Website:
Office Contact Person:

Specialties

Specialty 1:*
Specialty 2:
Specialty Focus and Special Skills: (Describe- 12 words or fewer)
Medical School Name:
Medical License State (Primary):

Other States:

IME Certification (check)

CIME (ABIME)
CICE (ABIME)
FAADEP
CDE (NADEP)
Others:

Years Practicing Medicine:
Years Performing IMEs:
Approximate Number of IMEs You've Performed:(optional)

Approximate Number of Times You've Been Deposed or Testified:(optional)

What formal IME training have you had?- Optional (check)

SEAK
AADEP
ACOEM
NADEP
ABIME
Other:

I hereby attest under the pains and penalties of perjury that the information I have provided is true and accurate to the best of my knowledge. Inconsideration for SEAK, Inc. publishing the above information to prospective IME requesters, I hereby agree to indemnify, hold harmless and defend SEAK, Inc. , its agents, employees and attorneys from any and all damages, claims, suits, actions, attorneys fees, costs and or judgments arising from any knowing falsehoods or inaccuracies contained in the above application.

I Agree