Physicians Immediate Care - Urgent Care Centers

Occupational Health / Worker's Comp Registration

Save Time and pre-register with our convenient downloadable forms. Just select the service or treatment you need, then print and complete your registration forms before you arrive.

Occupational Health and Work Comp Early Registration Forms:

Just choose the appropriate form(s) you need from the following list. They will be displayed in a new window for you to print and fill out.

Occupational Health Registration
Employers who will be sending staff to Physicians Immediate Care for a drug screen or physical:

Occupational Medicine Account Application Form

Worker's Compensation Registration
If you were injured at work or on the job:

Workers Compensation Authorization Form

For more information, please contact: Katelyn Johnson, Occupational Marketing.
Phone: 772-343-1774

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