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Home > Medical services > Occupational health > For our clients > Employer referral form
To refer an employee for occupational health services at ProHealth Care, complete the form below and click submit. Or, you or your employee can print the form below, fill it out and bring it to a ProHealth occupational health services location.
If your company currently has a relationship with ProHealth Care, you may refer your employee by downloading and completing the Employer Treatment Authorization form (PDF).
If you don't have a current account with Occupational Health Services, please contact Lisa Geracie at 262-928-5912.
262-928-5900
located within ProHealth Medical Group Waukesha Clinic 1011 Spring City Drive Waukesha, WI 53186
located within ProHealth Medical Group Brookfield Clinic 195 Discovery Drive Brookfield, WI 53045
located within ProHealth Medical Group Sussex Clinic N57W24950 N. Corporate Circle Sussex, WI 53089
located within ProHealth Medical Group Mukwonago Clinic 240 Maple Ave. Mukwonago, WI 53149
located within ProHealth Medical Group New Berlin Clinic 13900 W. National Ave. New Berlin, WI 53151
located within ProHealth Medical Group Oconomowoc Clinic 1185 Corporate Center Drive, Suite 150 Oconomowoc, WI 53066
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