Download Forms
You can download our forms prior to your visit from the list below or refer to the particular service you are scheduled for under List of Services for a list of the forms necessary for the type of visit you are scheduled for. Please print and fill them out completely to expedite your visit with Cascade Occupational Medicine.
All forms are presented in PDF format. Adobe Reader or similar software is required to be installed on your computer in order to properly display and print these forms. If you do not have Adobe Reader installed on your computer, please click the icon at the bottom of the page.
Service Authorization Form (483k)
Initial Medical and Work History (578k)
Patient Registration (236k)
Consent for Contracted Services (288k)
Consent for Injury Care (288k)
DOT Driver Fitness Medical Examination Report (457k)
Spirometry Pre-testing Questionnaire (318k)
Asbestos Exposure Questionnaire (366k)
Audiological History (310k)
Company Profile Update Form (124k)
Consent for Physical Capacity & Exercise Test (299k)
Consent for EKG Treadmill Stress Test (292k)
Injury Care Initial Patient History (1,110k)
OSHA Respirator Questionnaire (286k)
Form 801: Report of Job Injury or Illness (15k)
A Guide for Workers Recently Injured on the Job (24k)
Employer-at-Injury Program (EAIP) Reimbursement Request Form (90k)
