• Background Screening Login
  • iSYSTOC Login
  • THRIVE: Work Health Solutions Blog
918-609-1600
  • Home
  • About Us
  • Services
  • Leadership
  • Forms
  • Contact Us
  • Home
  • About Us
  • Services
  • Leadership
  • Forms
  • Contact Us

Medical Authorization

Home » Medical Authorization
Employee Name(Required)
Hidden
If email address is entered, employee will receive notification with instructions and address for Work Health Solutions
Reason for Visit: Please select only one(Required)
Post Injury Substance Abuse Testing (Not Required):
Send Bill to:(Required)
Reason for Testing:(Required)
Physical Exam:
Physical Abilities Test/ Job Function Test:
Substance Abuse Testing:
Drug Screen Observation/Witness Collection:
DOT Agency(Required)
DOT Agency(Required)
DISA: If you do not know what DISA stands for, please do not complete this section
DOT Agency(Required)
DOT Agency(Required)
Respiratory Services:
Masks:(Required)
Masks:(Required)
Additional Services:
Vision Testing(Required)
Audiogram(Required)
COVID - 19 Testing

© 2022 Work Health Solutions. All rights reserved.