Online Medical Forms

Thank you for considering HealthWorks-WNY for your occupational health needs. Select the type of service you require from below, and you will be able to download the form(s) that you require.

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Patient Services 


Please bring photo ID (NYS Drivers license) and a list of your medications to your appointment. Please plan on arriving 15-20 minutes prior to your appointment time.

If you have any questions regarding the completion of this paperwork, please call our office for assistance.

Northtowns clinic - 2075 Sheridan Drive - 716.447.6474, option 2.

Southtowns clinic - 1900 Ridge Road - 716.712.0670, option 2.