Occupational Health Interest Form

QUICKmed works with many local employers and provides Occupational Health Services such as drug screens, employee physicals, health education, and treatment of work-related injuries.


Are you interested in the Occupational Health program? To get started please fill the information below and a QUICKmed representative will contact you shortly.

  • Your Information

    (Primary Contact)
  • Company Information

  • (If different than Primary Address)
  • (Check all that apply)
  • (If yes, please select which level)