Forms & Questionnaires

Access forms and questionnaires you may need when you work with or get occupational health services from Olmsted Medical Center (OMC).

Contact us at 507-292.7144 with questions. Submit your form by fax at 507.292.7001.

For Business Owners

Download the following forms if you're a client of OMC:

For Patients

Save time by completing the following forms.

Patient Record Release & Health History Forms

Authorization for Occupational Health Services [PDF]
Authorization for After-hours Occupational Health Services [PDF]
Exposed Patient Consent for Testing for Occupational Exposure to Blood or Body Fluids [PDF]
Medical Examination Report for Commercial Driver Medical Certification [PDF] (Department of Transportation, or DOT, form)
Occupational and Health History [PDF]

Patient Questionnaires