1300 N. Kraemer Blvd., Anaheim, CA 92806
Hours: Monday - Friday 7:30 AM - 6 PM
Tel: 714-630-6363
Fax: 714-630-6318

"Keeping You on Your Job is Our Job"
Printable Forms for Employers and Employees
Employee/Patient Forms
English and Spanish forms are available here to fill out prior to your visit. Save time by having them completed & ready when you check-in.
Injury Forms
Health Questionnaire - English or Spanish
Authorization for Release of X Rays and Medical Records
Consent to Release Medical Information
(Consentimiento Para Traspasar Informacion Medical)
Misc. Forms
(Registro de Evaluation Audiometrica)
OSHA Recommended Questions for Respirator Evaluations - English or Spanish
Physicals and Screenings
Drug/Alcohol Screening Consent Form - English or Spanish
Pre-Placement Physical Consent Form - English or Spanish
Consent to Release Medical Information
(Consentimiento Para Traspasar Informacion Medical)