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At U.S. HealthWorks, we want to make things easier for employers and their employees. In this section, employers are able to print/fill forms at any time, in the convenience and comfort of their own home or office, pay their bills online and have 24/7 web access to their employee’s case status and customized reports. U.S. HealthWorks continually strives to provide convenient solutions for you.
FORMS
For EMPLOYERS (Treatment Authorization Forms)
Prior to an employee being provided services at one of our medical centers, we request that a Treatment /Service Authorization form be filled out by the employer or designee. This form should be brought by the employee at the time of service. In addition to medical treatment, all services required by the employer (including drug and alcohol tests) must be requested on the Treatment /Service Authorization form.
  • Treatment Authorization Form FOR PRINT (English)/(Español)
  • And NOW, a Treatment Authorization Form You can SUBMIT ONLINE (Click Here)
For EMPLOYEES/PATIENTS (Intake Forms)
Employees and applicants can fill out these forms, at their convenience, prior to arriving at one of our medical centers. Bringing the forms to the clinic already completed, will help shorten the registration process. Otherwise, the forms will be provided upon arrival by our front desk staff.
  • WC Patient First Visit Intake Forms (English)/(Español)
  • WC Patient Follow Up Visit Intake Forms (English)/(Español)
  • Pre-Placement Physical Exam Intake Forms (English)/(Español)
  • DOT Drug-Alcohol Testing Intake Forms (Forms are not needed / Formas no son necesarias)
  • Non DOT Drug-Alcohol Testing Intake Forms (English)/(Español)
  • Non DOT Breath-Alcohol Testing Intake Forms (English)/(Español)
  • Commercial Driver Physical Exam Intake Forms (English)/(Español)
ONLINE PAYMENT
The U.S. HealthWorks online payment service allows you to conveniently pay your bill on our site via credit/debit card or check. With a few clicks, you'll have paid your bill - all while saving time and money on postage and check writing fees. It's easy, fast and secure.
GO TO ONLINE BILL PAY
CLIENT COMMUNICATION SYSTEM
The Client Communication System (CCS) is a free service available to all our U.S. HealthWorks clients. You’ll be given 24/7 online access to your injured employees case status, as well as reports that can be customized for your company such as summarized case statistics and more.
LEARN MORE ABOUT CLIENT COMMUNICATION SYSTEM
ALREADY A USER OF CCS? LOG IN HERE
EMPLOYER FEEDBACK
Please take a moment to give us your feedback about your experience with U.S. HealthWorks. Quality healthcare is built on the opinions and comments we receive from you and we care!
SEND US YOUR FEEDBACK
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