Forms

If you are visiting Occupational Health for the first time, you will complete your forms in our office on an iPad or you can sign up for MyChart to begin your registration.

Declination Forms

• TDAP Declination Form
• Hepatitis B Declination Form
• Rabies Declination Form

Worker's Compensation, Employer's First Report of Injury or Illness

• Incident Reporting and Referral for Medical Treatment Forms
• How to Fill Prescriptions Form
• Concentra Employer Authorization Form
• Student Worker Employment Verification

Tuberculosis

• TB Screening Form
• TB Requisition Form
• TB Clinic Collection Instructions