work health solutions
forms

New Client Form

• Please complete pages 1-3 and send back to Jeremy Green l jpgreen@workhs.com.
• If you have questions, please call him at 918.402.1179.
• He will be in touch ASAP to schedule an in-person meeting to discuss your risk management strategy and services required.

Authorization for Treatment

If you have an emergency during normal business hours, please call us and let us help triage the problem.
This also helps us prepare for the injured worker.

Please complete electronically and submit to:

• frontdesk@workhs.com
• Fax: 918.609.1319
• You may now authorize services using this link:
  • https://www.workhs.com/medical-authorization/

24/7/365 Afterhours Drug and Alcohol Testing Hotline

• This form is commonly printed and posted at your facility.
• During normal business hours – call 918.609.1600
• Outside of normal business hours – call 918.229.0787
  • A trained technician will meet you at your facility or the emergency room to perform the UDS or BAT.

Injury Care and Pre-Employment Flyer and Map

• This form is commonly printed and posted at your facility.