Direct Downloads
PDF forms are copied locally and download from the current site.
Forms & Downloads
Forms for patients, employees, drivers, and employer accounts
Altmed patient, DOT, occupational, addiction, wellness, and records-release forms are organized here in one place. PDF forms download from this site, and online forms open the correct secure form entry.
If you are not sure which form you need, call (703) 361-4357 before your visit and our team can guide you.
Online Forms
Jotform entries open directly from the forms page without redirecting through the old library.
Secure Release Routes
Medical records and release routes stay easy to reach without losing the current URLs.
Occupational Health Forms
Occupational Health Forms
Employer, hiring, and workplace-health forms frequently requested by HR teams, drivers, and safety-sensitive employees.
Medical Exam Form (Police Officer and Fire Fighters)
Virginia initial-hire medical standards examination form for public-safety roles.
Download PDFNew Patient Registration (English)
Online new-patient registration form for general clinic visits.
Complete OnlineMedical Clearance Forms
Medical Clearance Forms
DOT and medical-clearance paperwork used when drivers need supporting records from specialists or treating clinicians.
391.41 CMV Driver Medication Form MCSA-5895
FMCSA driver medication form for DOT medical exam follow-up.
Download PDFNon-Insulin-Treated Diabetes DOT Clearance Form
DOT clearance form for non-insulin-treated diabetes medical review.
Download PDFVision Evaluation Report Form MCSA-5871
FMCSA vision evaluation report used when a driver needs additional vision documentation.
Download PDFInsulin-Treated Diabetes Mellitus Assessment Form MCSA-5870
FMCSA insulin-treated diabetes mellitus assessment form MCSA-5870.
Download PDFReturn to Duty / Work DOT Clearance Form
Return-to-duty and work-status clearance form for DOT physical follow-up.
Download PDFHypertension DOT Clearance Form
High-traffic DOT hypertension clearance form for blood pressure follow-up.
Download PDFCardiac DOT Clearance Form
Supporting cardiac clearance form for DOT medical exam follow-up.
Download PDFObstructive Sleep Apnea DOT Clearance Form
DOT sleep apnea clearance form for CPAP and sleep-study documentation.
Download PDFMedical DOT Clearance Form
General medical clearance form for drivers who need supporting DOT documentation.
Download PDFAddiction Health Forms
Addiction Health Forms
Confidential intake and follow-up forms used for addiction-treatment visits and medication-assisted care.
Suboxone Form for New Patient
Online intake packet for new Suboxone and addiction-treatment patients.
Complete OnlineSuboxone Follow Up
Online follow-up form for returning Suboxone and addiction-treatment patients.
Complete OnlineWeight Loss Forms
Weight Loss Forms
Medical weight-loss intake paperwork for specialty visits.
New Patient Weight Loss Intake Form
Online intake form for new medical weight-loss patients.
Complete OnlineWellness Forms
Wellness Forms
Wellness, hormone, IV therapy, and follow-up paperwork for specialty visits.
IV Nutritional Therapy (Patient Registration & Informed Consent)
Online IV nutritional therapy registration and informed consent form.
Complete OnlineTestosterone Therapy (Patient Registration & Informed Consent)
Online testosterone therapy registration and informed consent form.
Complete OnlinePain Management Follow Up Evaluation
Online follow-up evaluation form for pain management patients.
Complete OnlineMedical Release Forms
Medical Release Forms
Release and authorization forms for patients, employers, and authorized representatives.
Company Authorization Form
Authorization form used for employer-requested examination, treatment, testing, or injury services.
Download PDFMedical Records Request Form
Request access to medical records or release support from Altmed.
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