Forms For Your Visit

Downloadable forms for patients and employers

Urgent Care - Patient forms


Employer forms

  • Patient Information Form (English & Spanish) — 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.
  • 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.