Occupational Medicine Services


Occupational Medicine Services Establish an Employer Account Employer Registration (to establish account information) (PDF 96kb) Authorization for Treatment Authorization for Treatment / map (PDF 120kb) Patient Registration D.O.T. Drug Screen Collection Employer Screening - English Employer Screening - Spanish Work Comp Injury – English Work Comp Injury – Spanish	Physical Exam or Screening Pre-Placement Physical Examination – English (PDF 52kb) Pre-Placement Physical Examination – Spanish (PDF 52kb) OSHA Respirator Medical Evaluation Questionnaire – English (PDF 76kb) OSHA Respirator Medical Evaluation Questionnaire – Spanish (PDF 92kb) In-Office Drug Screen Consent – English (PDF 40kb) In-Office Drug Screen Consent – Spanish (PDF 40kb)

Establish an Employer Account