Authorization Form

From Occupational Medical CARE

Authorization and all other necessary forms will soon be available through the Glow Stream online portal.

Employers can call in to give a verbal authorization by providing a unique code. 

Complete the form below prior to visiting one of the Occupational Medical CARE locations.

Please note that this form will be reviewed by one of the OMC staff and is not to be considered an appointment. You will be contacted as soon as possible in order to set up an appointment.

Regards, Occupational Medical Care.

*Indicates required field.