Authorization to Treat Form
If you are sending an employee in to Brea Urgent Care for any sort of treatment, please complete this workplace form.
WorkComp Insurance Information
If you are sending an employee in to Brea Urgent Care for a workplace injury, please complete this form.
Commercial Driver Fitness Determination
If you are sending a Commercial Driver for a Medical Examination Report to determine fitness, please complete this form.
In order to release Health Care information, the following form must be filled out: