Medical Forms

Medical Authorization Form

Employers may use this form to authorize medical care for a work-related visit:

  • Pre-employment physicals
  • Post-accident drug screens
  • Work-related injuries
  • Breath alcohol testing
  • Vaccines and TB testing

Download Medical Authorization Form

Medical Records Release

Please print and complete the Medical Records Release form to allow Total Access Urgent Care to share a patient’s medical records. This form can be used to release lab results, physical forms, or a patient’s medical history to someone other than the patient.

Download Medical Records Release

Parental Authorization Form

The Parental Authorization form may be used to authorize Total Access Urgent Care to provide medical treatment for patients under eighteen years of age, in the absence of a parent or legal guardian.

Download Parental Authorization

Missouri Sports Physical Universal Form

Please complete the pertinent section of this form prior to arrival at Total Access Urgent Care for a sports physical.

Download Missouri Sport Physical Universal Form