Before your visit
Consent for services.
Fill this out before you come in. It covers treatment, testing, and how results reach your employer.
The consent for services says what care you agree to, that samples for drug and alcohol testing may go to a lab, and that results may go to your employer, potential employer, or insurance carrier as appropriate.
The full consent and release wording is on the form's second page, before you sign.
Doing it here saves time at the front desk. What you enter goes to the clinic, not to this website.
Have on hand
- Your employer's name, contact, and phone
- If this is an injury visit, the date and time it happened
Consent for services
Questions before you fill it out? Call 812.271.4240, Monday to Friday, 8:00am to 5:00pm.
Looking for something else?
- Employee door Find your visit and what to bring.
- Respirator questionnaire Required for a respirator clearance exam.
Getting here
- Directions
- Off I-65 at Exit 4.
- Parking
- Truck-friendly parking with room for a tractor-trailer.
- Hours
- Mon to Fri, 8:00am to 5:00pm
- Phone
- 812.271.4240
Satellite imagery from Google Maps; the truck route and legend were added.