COACHELLA:
760-398-0723
RIVERSIDE: 
760-398-0723
COACHELLA:
760-398-0723
RIVERSIDE: 
760-398-0723
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  • Locations
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    • Riverside CA
  • BLOG
  • More
    • Home
    • About Us
    • Employer Services
    • Employee Services
    • MPN Panels
    • COVID TESTING
      • COVID/FLU Testing
      • Onsite Business & School
    • Locations
      • Coachella CA
      • Riverside CA
    • BLOG

  • Home
  • About Us
  • Employer Services
  • Employee Services
  • MPN Panels
  • COVID TESTING
    • COVID/FLU Testing
    • Onsite Business & School
  • Locations
    • Coachella CA
    • Riverside CA
  • BLOG

EMPLOYER ACCOUNT PROTOCOL FORM

You may choose to complete the Employer-Account Protocol Form below which when completed will be forwarded to one of our Medical Assistants for Review.

This form is in 3 parts - Please complete ALL PARTS!

If you prefer, you can click on the button below which will open a FILLABLE PDF File - complete this form, print it, and email it to aruiz.ihmg@gmail.com

Click Here to access the Employer account protocol form

Employer Account Protocol Form PART 1

Employer Account Protocol Form

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Employer Account Protocol Form PART 2

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Employer Account Protocol Form PART 3

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  • Home
  • About Us
  • Employer Services
  • Employee Services
  • MPN Panels
  • COVID/FLU Testing
  • Onsite Business & School
  • Coachella CA
  • Riverside CA
  • BLOG

Industrial Health Medical Group

(760) 398-0723

Copyright © 2023 Industrial Health Medical Group - All Rights Reserved.

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