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Home > Health Resources > Injuries

Health
Resources

INJURIES
Essential Guide to Dislocation Treatment and Prevention
INJURIES
Concussions: Signs, Symptoms, and Treatment
INJURIES
Exploring Back Pain Treatment and Relief Options
ILLNESSES, INJURIES
What Does Black Stool Mean? Causes & Concerns
INJURIES, WELLNESS
How to Make Bruises Heal Faster
INJURIES
How to Know if a Wound is Healing or Infected
INJURIES, WELLNESS
Burn Care Simplified: From First Aid to Recovery
INJURIES
How to Treat a Cut: From First Aid to Healing
INJURIES
Quick Guide: How to Treat a Burn and Soothe Your Skin Fast
INJURIES
Easy and Painless Ways to Remove a Splinter
INJURIES
A Guide to Muscle Strain Treatment and Recovery
INJURIES
Exploring Causes and Effective Treatment of Shin Splints

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Interested in learning more about selling your practice or joining the NextCare family of brands? Complete the form below, and we will be in touch shortly. You can also email us at contactus@nextcare.com

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Number of employees:

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Is your billing address the same as your physical address?

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Will your company use NextCare for the treatment of work related injuries?

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How would you like the work statuses reported?

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Name

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Any additional comments or special instructions?

Will your company use NextCare for drug testing?

No

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Drug screen services are billed to:

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Who is the Designated Employer Representative?

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Lab and Medical Review Officer Services (MRO):

Full Service (use NextCare’s Lab and MRO)

Collection Only (use your company’s existing Lab Account and MRO)

Drug Screen Collection Method:

Urine

Hair

Saliva

Other

Testing Type:

*Rapid testing is not available in our Kansas market. Non-negative rapid test results are sent-out to lab for confirmatory testing and MRO review prior to result reporting.

Send-out to laboratory for testing (results available in 3-5 days)

Rapid / Quick Test (negative test results available same day)*

Rapid / Quick Test Panels:

5 Panel Rapid

11 Panel Rapid

Other

Send-Out Panels:

5 Panel

9 Panel

10 Panel

12 Panel

Other

Would your company be interested in learning about NextCare’s random management program?

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Name of Lab

Lab Account Number

Reason for Test:

Pre-Employment

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Post Accident

Follow-Up

Secured Method of Reporting

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Email

Additional Notes/Comments:

Would you like to add another drug screen to your account?

Yes – An Occ Health Team Member Will Follow Up For More Details

No

Will your company use NextCare for physical examinations?

No

Yes

Basic Physical (includes vitals, review of medical history and physical exam)

DOT Physical

Return To Work

Other

Physical Services are billed to:

Company

Third Party Administrator (TPA)

Candidate/Employee

Name of TPA

Authorized recipients:

Primary Contact

Secondary Contact

Other

Name

First Last

Phone

Secure Fax

Email

NextCare offers many other Occupational Health services, please use this box to list any other testing, vaccines, lab testing or other services you may need.

Find Your Location
- Arizona
- Colorado
- Kansas
- Michigan
- Missouri
- North Carolina
- Oklahoma
- Nebraska
- Texas
- Virginia
- Wyoming
Plan Your Visit
What We Treat
Health Resources
Occupational Health