Occupational Health Authorization Form
PHYSICALS AND EVALUATIONS REASON FOR DRUG/ALCOHOL TEST. Injury Evaluation. Pre-placement. DOT Physical. Annual. Pre-placement Basic Physical. ... 10 Panel Quick Test. BREATH ALCOHOL & VACCINATIONS. 10 Panel Send In. DOT Breath Alcohol Testing. ... Please FAX required authorization form to: Occupational Health & Wellness at 815-971-9574. X ... ................
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