Employer Services Inquiry

Well-Key Urgent Care -
Where the Doctor is Always In

Name of Company: (required)

Location Address:

City:

State:

ZIP:

Corporate Address (If Applicable):

City:

State:

ZIP

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Contact Phone: (required)

Number of Employees:
0-50 Employees51-150 Employees150+ Employees

Services (check all that apply):
Worker’s CompensationPost-Accident Drug ScreensDOT (Department of Transportation) PhysicalsSaliva Alcohol Levels TestingWork PhysicalsPre-Employment Drug ScreensDiagnostic Testing/VaccinationsPost-Hire/Pre-Placement Physical Capacity TestingFit for Duty Testing Post-Injury



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