Occ Med Information Request | CommunityMed Family Urgent Care

Occupational Medicine Inquiry for Pre-Employment and Work Injury

CommunityMed provides easy access to pre-employment and work-injury services. After completing the inquiry form below, someone from our team will be sure to contact you within 1 business day.

Company Name
Main Contact Name
Main Contact Phone
Main Contact Email
Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Which best describes your company?
- Utilize Workman's Compensation
- Non-Subscriber
- Neither
Please select the services you are interested in below:
- Pre-Employment Physicals and/or Drug Screens
- DOT Physicals
- Work-Injury
- Vaccines/Titers
- Breath Alcohol Testing
Additional services you would like us to provide (please describe):