top of page
WEBSITE DESIGNED & ADMINISTRATED BY DARREN/BEN NGUYEN.

IMMEDIATE MEDICAL CENTER
Please select your clinic:

Please select the services that apply to you:
WORK-RELATED
PHYSICAL EXAMS
DRUG TESTING
DOT PHYSICAL
SERVICES REQUESTED
ONLINE AUTHORIZATION
Your form has been successfully submitted!
Please fill in the required information
AUTHORIZATION FORM
bottom of page