Resources & Tools
Patient Resources
Registration Forms
Patient Registration Package
Please fill out these forms prior to your visit to save time on your arrival.
Paquete de registro de pacientes
Complete estos formularios antes de su visita para ahorrar tiempo a su llegada.
DOT Physical Forms
DOT FORM 5875
Medical Examination Report Form shows a driver what to expect during their examination.
This form does not need to be completed before your visit.
DOT FORM 5876
Medical Examiner's Certificate Form is another example of what a driver can expect during the physical exam. Certified drivers will receive their MEC after the exam is completed.
DOT FORM 5870
Insulin-treated Diabetes Mellitus Assessment is for commercial drivers with insulin-treated diabetes. Drivers must have this form completed by their physician no more than 45 days prior to the DOT Physical. This form is required before a Medical Examiner's Certificate Form MCSA-5876 can be issued to a certified driver.
Notice of Privacy Practices
Notice of Privacy Policy
A guide to our patients privacy rights.
Aviso de política de privacidad
Una guía de los derechos privados de nuestros pacientes.
Employer Tools
Create an Account
Employer Information
Use this form to set up an account with Agile for your employees health and safety.
Treatment Authorization Form
Treatment Form
Use to authorize an emploee to visit the clinic for testing or a workplace injury.
Credit Authorization Form
Credit Authorization
Use this form to have all non-inurance charges billed to your company credit card.
Clinic Locations List
Clinic Locations
Complete listing of all our facility addresses and contact information on one convenient sheet
Information Sheets
DOT Physicals
Complete information on our DOT Physical screening programs for individual drivers and fleet operators
THC Screening Compliance
Complete information on our screening compliance for new regulations under CA AB 2118
Injury Treatment
Complete information on our comprehensive care for workplace injuries
Telemedicine
Complete information on our telemedicine programs for remote care of injured or ill workers
Workplace Posters
Anaheim
Bakersfield
Delano
Emeryville
Gardena
Glendale
Hollister
King City
Los Banos
Mission Hills
Redding
Sacramento
Salinas Blanco
Salinas Main
Salinas Rossi
San Leandro
Santa Cruz
Soledad
Stockton
Watsonville
Wilmington
Yuma