Southtowns

716-712-0670

Northtowns

716-712-0670

Patient Services

Thank you for considering HealthWorks-WNY for your occupational health care needs. If you are interested in completing paperwork prior to your visit, please select your service(s) from the options list below, print the form(s), and complete the appropriate section(s).  Please bring the completed paperwork to your appointment.

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On-the-Job-Injury  


Physicals  


DOT Physicals  


Drug Screening, Breath Alcohol, Audiogram, PPD & All Other Treatment Services 


OSHA Respirator Questionnaire 


Asbestos Exam - Initial 


Asbestos Exam - Periodic 


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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