Employer Testing Authorization

Generate a clinic-ready authorization for employee exams, drug and alcohol testing, occupational health services, or rehabilitation visits.

Let's Connect

Get in touch with your customers to provide them with better service. You can modify the form fields to gather more precise information.

Company name *

Authorized contact *

Email *

Subject *

Phone *

Billing code, PO, or account note

First name *

Last name *

Date of birth *

Employee phone

Employee ID or last 4 A short identifier helps match the visit without collecting unnecessary sensitive information.

Requested date

Authorization good through *

Spanish-speaking support requested

Additional comments

Generate Authorization

Integrated Care provides specialized rehabilitation and occupational health services for Omaha businesses.

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