Forms:
Occupational Health Employer Authorization Form
Please complete this form and send with each applicant or employee coming to MedCentral for services.
>>Download Form

Occupational Health Required Consent Form
Complete this form and bring to MedCentral to expedite registration process.
>>Download Form

MedCentral Workers Comp Required Consent Form
Complete this form and bring to MedCentral to expedite registration process.
>>Download Form  

A wide range of services can be tailored to employers' specific needs:

• Acute injury and follow-up care
• Physicals: Pre-employment, DOT, FAA, & specialized
• CRT Testing services. CRT testing modalities include
  pre-employment, baseline and Return To Work. The CRT machine
  tests 3 major parts of the body prone to be involved in costly
  Workers’ Comp claims, knees, shoulders and back/core. MedCentral
  has partnered with Scott Insurance to provide these services. Refer
  to link below for demonstration of exercises performed on the CRT
  machine.



• Case management of difficult or complicated workplace injuries
• Testing: Drug and alcohol, Titmus vision,
  hearing (audiometry), pulmonary function
• Work-site medical services
• Employee Assistance program
• Wellness & Fitness Program
• Executive/VIP Health
• Rehab services
• Industrial Rehabilitation:
  Functional Capacity Evaluation, Work Conditioning and Hardening,
  Pre-Placement Screening, Physical Agility Test, Injury Prevention - Back   Schools & Flex & Stretch Programs, Job Site Analysis

Employers may contact Mary Beth Nelson, Corporate Accounts Consultant at mnelson@medventures.net for questions regarding occupational health services.

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DOT regulations indicate a person who seeks qualification to drive a commercial motor vehicle should not have any medical conditions that could interfere with the ability to safely operate a commercial motor vehicle.

A person with certain medical conditions can receive DOT certification if the condition is controlled per DOT standards and proper documentation is available for the medical examiner’s review.

Some of the medical conditions requiring documentation of control are:

Diabetes, Cardiovascular conditions (heart attack, heart surgery, stent, pacemaker, etc), Coumadin therapy, Sleep apnea, and
Seizure disorders.

In order to expedite the DOT certification exam process, the prospective driver should obtain medical records prior to the appointment so that the medical examiner can review the records at the time of the exam. Links to PDF forms for a variety of medical conditions are listed below. Each form outlines what is needed to document control of each specific medical condition and should be signed by the prospective driver’s health care provider.

Select, print and complete each form below that pertains to your medical condition:

Cardiovascular Assessment Form
>>Download Form

Undergoing Coumadin Therapy Form
>>Download Form

Seizure Disorder Form
>>Download Form

Diabetes DOT Form
>>Download Form

High Blood Pressure Form
>>Download Form

Physical Form
>>Download Form

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Affordable medical treatment billed at hourly rates for on-site medical services increases your company’s productivity since employees do not have to travel to a clinic.

On-site medical services can provide:
• Testing: Drug and alcohol, Titmus vision, pulmonary function
• Pre-assessment portion of pre-placement/annual physicals
• Worker’s Comp follow-up care
• Referrals to local healthcare professionals
• Immunizations
• Injury Triage
• Work Injury Management
• Accute illness healthcare

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