Workplace Forms

Authorization to Treat Form

If you are sending an employee in to Newport Urgent Care for any sort of treatment, please complete this form.

Download and Print Form

WorkComp Insurance Information

If you are sending an employee in to Newport Urgent Care for a workplace injury, please complete this form.

Download and Print Form

Commercial Driver Fitness Determination

If you are sending a Commercial Driver for a Medical Examination Report to determine fitness,   please complete this form.

Download and Print Form

In order to release Health Care information, the following form must be filled out:

Authorization to Release Health Care Information

    • img
    • img
    • img
    • img
    • img
    “The whole team are extremely helpful and actually care about your well-being and helping you out. Some of the staff that really stood out and went above and beyond Odessa – PA...

    Marie Fitch

    • img
    • img
    • img
    • img
    • img
    “This was the nicest, cleanest, fastest urgent care I’ve ever been to. I only waited an hour. Everyone was kind and helpful. I will be coming back here the next time I need car...

    Anne B

    • img
    • img
    • img
    • img
    • img
    “Repaired a sliced thumb without delay; carefully examined and exhaustively cleaned multiple times, brilliantly taped up to avoid the need for stitches and it resulted in it healing ...

    Jim F

    • img
    • img
    • img
    • img
    • img
    “I went in today for a drug screening and was disrespected at the most part after I got in as an African American and they seen who I was 1 of the guys working there pushed me for no...

    Tone Bee

    • img
    • img
    • img
    • img
    • img
    “Wow. I just came here freaking out feeling like I couldn’t breathe. The front desk lady was very nice and said There are 7 people in front of me. I asked her if she could at l...

    Kimberly Morrow

Blog Categories Menu