Southtowns

716-712-0670

Northtowns

716-712-0670

Client Companies

Thank you for considering HealthWorks-WNY for your occupational health care needs. Please select from the following option(s) below, print the necessary form(s), complete them and return them to our Marketing Department.  Please email them to rcostanza@healthworkswny.com and pwoeppel@healthworkswny.com or fax them to 716.877.3027.

For questions regarding these forms, please call 716.712.0670 x 3258.

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New company client enrollment form - to be completed by new clients only  

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Authorization to Permit Examination or Treatment  

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iSystoc Agreement - online resulting  

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