Human Resources
Current Employee Downloadable Forms
Click the button below each form to dowload it.
Information on Conversion vs Portability
Click the link to find a location near you and schedule an appointment or walk in.
Please click below for the authorization form and summation letter.
You must bring both forms with you.
Docsnet STD Intake
Click the link to find a location near you and schedule an appointment or walk in.
Please click below for the authorization form and summation letter.
You must bring both forms with you.
Application for Portability
Call to make an appointment.
814-913-3097
655 E DuBois Ave
DuBois PA 15801
814-913-3097
Hours: Mon - Sun 8a-8p
Click below for the authorization form.
Application for Conversion
Call to make an appointment.
814-849-1874
Brookville Medical Office Building
88 Hospital Rd., 1st Floor
Brookville, PA 15825
Hours: Mon- Fri 9a – 6p
Click below for the authorization form.
