Have an established account with us? Please fill out the form below, or click here to download a blank form. If you need to set up an account, please contact our Occupational Health Sales Team: 847-257-5616.
If you have encountered any problems with our website or the Medical Authorization form, please contact our Webmaster.
Please note that the following Occupational Health procedures will only be offered daily until 6 pm:
- Employment physicals (both pre-employment and annual)
- Pre-employment drug screens (both regulated and non-regulated)
- All other Occ Health services
A few important exceptions: After 6 pm, we will continue to perform all post-accident, reasonable suspicion, and random drug/alcohol screens. In addition, we will continue to perform Workers’ Comp injury care. We apologize for any inconvenience.
Please note: Patient Must Present Photo ID at Time of Service. Please check the individual clinic pages for any temporary changes in clinic hours during the pandemic.