We remain dedicated to making service to all customers the cornerstone of our operations and as part of our service we have made available the below forms. By clicking once on a specific form, you have the option of completing it online and printing OR printing the form and completing by hand.
Adobe Reader is used for some of documents on this site and is free software to view, fill out and print forms (Adobe Portable Document Format (PDF)). If you don't have it, go to the Adobe website and download Adobe Acrobat Reader. If you have problems with Acrobat Reader, visit PDF Troubleshooting.
To obtain a form by mail or fax, call during our business hours (7:30 a.m. and 5:00 p.m.) and speak to an operator.
- Employer Treatment Authorization Form - Fill-In
- TB Questionnaire - Bilingual
- Respiratory Questionnaire Bilingual
- New Account Information Form
- Account Information Update
- CPR and First Aid Training
- Medical Examination Report
- Medical Examination Report (Spanish Version)
- Travel Medicine Questionnaire
- Basic Health Screening Questionnaire
- Patient Information Form