Fitness-for-Duty Scheduling

Please use the following form to request an appointment for a Fitness-for-Duty evaluation.  

Based upon your request(s), we will call to confirm your information and e-mail you a schedule confirmation within 1 business day.  Thank you.

Don’t want to send your personnel to our office?  Check out our ClearPath™ program by clicking here.

Have you used Public Safety Medical in the past?
Invoices Should Be Sent To:

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Reason for Visit
Use Drop Down

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Use Drop Down
i.e. broken left arm, torn left leg ACL, rotator cuff tear in right shoulder, showing signs of depression, etc.
Psychological Evaluation Questions

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Maximum file size: 2MB

Maximum file size: 2MB

Maximum file size: 2MB

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STOP: PSM Use Only

EXAM TYPE