Important info for clients

at your fingertips

For your convenience: Use these links to access current form, portals and resources that you need as an employer partner with Well at Work:

AUTHORIZATION FORMS

  Authorization Form   Company Change Request Form

WORKERS COMP

  Notice: Medical Treatment for Work Injury   WellSpan Preferred Provider Panel

RESPIRATOR FORMS

  Respirator Medical Evaluation (OSHA) and Fit Testing Process Form   Respirator OSHA Employer Questionnaire Form (English)   Respirator OSHA Employer/Employee Questionnaire Form (Spanish)   Respirator OSHA Employee Demographic Form   Respirator OSHA Employee Questionnaire

ADDITIONAL FORMS

  Flu Vaccine Pre-Order Form   On-site Flu Vaccine Registration   Travel Questionnaire for International Travelers

DOT DRUG TESTING REFERENCE

  You've tested positive for drugs or alcohol. Now what?   What Employers Need to know about DOT Drug & Alcohol Testing   DOT's Direct Observation Procedures

EMPLOYEE ASSISTANCE PROGRAM

  WellSpan Employee Assistance Program   WellSpan EAP Supervisory Referral Forms

OCCUPATIONAL HEALTH

  Find a location near you

iSystoc

  iSystoc Login

Wellness Site

  Wellness Site Login

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