Online Medical Forms
Thank you for considering HealthWorks-WNY for your occupational health care needs. Select the type(s) of service(s) required from the options listed below, and proceed wth downloading the necessary form(s).
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 - 716-712-0670, option 1.
Southtowns CLINIC - 1900 Ridge Road - 716-712-0670, option 2.
Patient Services
On-The-Job Injury
Physicals
DOT Physicals
Drug Screening, etc
OSHA Respiratory
OSHA Respirator Questionnaire Forms are now available for on-line completion. Complete it ahead of time and save valuable time.
Follow the 4 steps below to submit the online medical form application.
- Click here to open the form in a new tab
- Fill in the information
- Save it to your desktop
- Attach the file to the from below and send