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Forms for Authorization for Corporate Care Services

Employers and employees must complete the following forms for authorization for Corporate Care services.

In addition to forms below, please be certain to bring photo proof of identification, such as a driver's license or work ID card. Minor employees who need treatment must be accompanied by a parent or legal guardian, or must have a notarized statement from the guardian or parent authorizing the employer to give permission for treatment as needed.

For New Injury or First-Time Visits

We must have authorization from your company/employer to administer treatment without delay.

Employers should provide injured/sick employees with a completed and signed Employer Authorization Form for presentation at the first visit.

Post-Offer Pre-Employment Physical Form

Medemerge
1005 North Washington Avenue
Green Brook, NJ 08812
(732) 968-8900
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RWJBarnabas Health Corporate Care - Lakewood
1195 Route 70, Suite 1000
Lakewood, NJ 08701
(732) 942-5851
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RWJBarnabas Health Corporate Care - Jersey City
414 Grand Street
Suite 17
Jersey City, NJ 07302
(201) 915-2750
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RWJBarnabas Health Corporate Care – Belleville
1 Clara Maass Drive
Belleville, NJ 07109
(973) 450-2523
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RWJBarnabas Health Corporate Care – Elizabeth
240 Williamson Street
Suite 202
Elizabeth, NJ 07202
(908) 994-5368
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RWJBarnabas Health Corporate Care – Hamilton
2 Hamilton Health Place
Hamilton, NJ 08690
(609) 631-6830
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RWJBarnabas Health Corporate Care – Long Branch
300 Second Avenue
Long Branch, NJ 07740
(732) 923-6745
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RWJBarnabas Health Corporate Care – New Brunswick
181 Somerset Street
3rd Floor
New Brunswick, NJ 08901
(732) 937-8714
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RWJBarnabas Health Corporate Care – Newark
365 Osborne Terrace
Newark, NJ 07112
(973) 926-7224
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RWJBarnabas Health Corporate Care – Somerville
110 Rehill Avenue
Somerville, NJ 08876
(908) 685-2838
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RWJBarnabas Health Corporate Care – West Orange
101 Old Short Hills Road
Suite 415
West Orange, NJ 07052
(973) 322-6450
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Employee and Occupational Health Treatment & Care

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