Forms for Authorization for Corporate Care Services
Employers and employees must complete the following forms for authorization
for Corporate Care services.
In addition to forms below, please be certain to bring photo proof of identification,
such as a driver's license or work ID card. Minor employees who need
treatment must be accompanied by a parent or legal guardian, or must have
a notarized statement from the guardian or parent authorizing the employer
to give permission for treatment as needed.
For New Injury or First-Time Visits
EMPLOYER AUTHORIZATION FORM (PDF)
We must have authorization from your company/employer to administer treatment
Employers should provide injured/sick employees with a completed and signed
Employer Authorization Form for presentation at the first visit.
Post-offer Pre-employment Physical Form
Physical Form (PDF)