Concentra's New Employer Portal lets you access employee test results, reports, authorizations, and more. The cloud based system allows you to receive immediate updates to your accounts via any internet-accessible device.
Insulin-treated Diabetes Mellitus Assessment MCSA-5870 - Commercial drivers with insulin-treated diabetes need to have this form completed by their treating clinician no more than 45 days prior to examination by a certified medical examiner (CME). This form is required before a Medical Examiner's Certificate Form MCSA-5876 can be issued to a certified driver.
Patient Information Form— Every patient must complete and sign this form for his/her visit. The completed form is permanently filed in the patient’s chart. This form may be printed and completed in advance, or a copy will be made available when the patient/employee arrives at a Concentra location.
Injury Information Form— This form gives your doctor more information about your injury. If you’ve been injured, please complete this form in addition to the patient information form and bring it to your visit.
Employer Authorization Form — We must have a completed and signed Employer Authorization Form for any patient coming to a Concentra Medical Center for treatment of a first-time or new injury.
Periodic Asbestos Questionnaire: Please print and complete this required form before all annual asbestos medical surveillance exams following your baseline asbestos exam.
Travel Health Questionnaire – Every travel health patient obtaining a travel health consult must provide their travel itinerary, health and vaccine history prior to their consultation. Please print and complete this form prior to your visit.