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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