Occupational Medicine Forms 

Click to download the PDF files of the forms. 

Respirator Medical Clearance

We perform N-95 respirator fit testing and medical clearance to use the respirator. Questions? Call 906.449.1140.

OSHA Respirator Medical Evaluation Questionnaire

Service Account Activation

Service Authorization for Account Activation

Ownership Certfication for Account Activation

Injured Workers

Lisa Smith, FNP-C specializes in work-related injury and illness care, return to work programs and certified medical examiner (DOT) physicals. Lisa Smith sees patients both in Marquette and Escanaba.

Michigan Workers' Disability Compensation Rights and Responsibilities

Workers Compensation Authorization Form 

For more information or to make an appointment, please call (906) 449-1140 Marquette or (906) 786-0440, Escanaba.