Employer Forms

Employment Service and Work Comp Forms

MED7 ® Employer Forms

For the convenience of our patients, here are some of more common forms we use at MED7 ® Urgent Care. They are available for download in the PDF format.

Treatment Authorization Form

This form may be printed and used to direct an injured worker to the nearest MED7 ® clinic. It has a convenient map, hours of operation and telephone numbers, and a listing of services. MED7 ® maintains a database of routine services for your company. We realize those services may need to be altered on a case-by-case basis. This form can be used for that purpose.

Employment Services Form

This form is used to set-up an account for pre-employment services. Once completed, please fax to (916) 483-1937. A representative will contact you shortly.

Workers' Compensation Form

This form is used to designate MED7 ® as the facility of choice for your injured workers. Please complete and fax to (916) 483-1937. A representative will contact you shortly.
 

MED7 ® Is Here to Help!

Find a location and visit a MED7 ® today!