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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 or Terry Miller at 262-928-5944.
located on the ProHealth Waukesha Memorial Hospital campus
721 American Ave., Suite 310
Waukesha, WI 53189
located within ProHealth Medical Group Brookfield Clinic
195 Discovery Drive
Brookfield, WI 53045
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
located within ProHealth Medical Group Sussex Clinic
N57W24950 N. Corporate Circle
Sussex, WI 53089
Log in to the iSYSTOC employer portal, your resource for test results, work injury reports and more.