Welcome to our secure intake portal. If you’ve been instructed by your employer to complete an OSHA or state
mandated form, please follow the steps below:
Select the Appropriate Form
Use the dropdown menu to choose the intake form that corresponds to your evaluation (e.g., Lead Surveillance, Respirator Clearance, Hearing Conservation, etc.).
Complete the Form in Full
Carefully fill out all required fields. Incomplete forms may delay your evaluation.
Submit Your Form
Once completed, click the Submit button at the bottom of the form. Your responses will be securely transmitted to one of our BoardCertified Occupational Medicine Physicians for review.
What Happens Next
After review, a physician may contact you to discuss your intake form and will complete the necessary medical assessment. A report containing only the required employer-facing information (such as work clearance status or recommendations) will be sent directly to your employer.