Employer Authorization Home»Employer Authorization We make it easy to meet workplace requirements. Submit your employer authorization form to streamline your care process. Provide the information below to get started quickly. Please enable JavaScript in your browser to complete this form.Full Name *Address *Email *Phone Number *Question/Comment of use, evaluating I consent to the collection, use, storage, and processing of my personal and, where applicable, health-related information, including any data I submit on behalf of others, for the purpose of evaluating or fulfilling my request made through this form. I understand this will be handled in accordance with the Privacy NoticeI consent to the collection, use, storage, and processing of my personal and, where applicable, health-related information, including any data I submit on behalf of others, for the purpose of evaluating or fulfilling my request made through this form. I understand this will be handled in accordance with the Privacy Notice.Submit