Now accepting Telehealth appointments. Virtual Visits are available starting October 19th.

Forms

Please select your appropriate form from the choices below. If you have any questions, please contact our office at 805-922-8282.

Employer Treatment Authorization Form - Fill-In

TB Questionnaire - Bilingual

Respiratory Questionnaire Bilingual

New Account Information Form

Account Information Update

CPR and First Aid Training

Travel Medicine Questionnaire

Basic Health Screening Questionnaire

Patient Information Form

IMG WC Injury Patient Form

What we offer

Services

Physical Exams
Respirator Mask Fit Testing
Workers Compensation
Drug and Alcohol Testing
Safety Training
Occupational Health Monitoring
On-Site Medical Service
INS Physicals

Location

Industrial Medical Group of Santa Maria Valley
3070 Skyway Drive, Suite 106
Santa Maria, CA 93455
Phone: 805-922-8282
Fax: 805-925-2690

Office Hours

Monday 7:30 am to 5:00 pm Tuesday 7:30 am to 5:00 pm Wednesday 7:30 am to 5:00 pm Thursday 7:30 am to 5:00 pm Friday 7:30 am to 5:00 pm Saturday Closed Sunday Closed

Get in touch

805-922-8282

Forms

Services

Physical Exams

Respirator Mask Fit Testing

Workers Compensation

Drug and Alcohol Testing

Safety Training

Occupational Health Monitoring

On-Site Medical Service

INS Physicals

Location

Office Hours

Get in touch