New Account Sign Up

Let’s get your team ready for care. Complete your company details, choose your services, and tell us who needs access.

Step 1 Of 6
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A Little Help Along The Way.

Questions about your account or services? Our team is here to help.

Mobile(251) 434-6770 ↗Pascagoula(228) 762-4642 ↗
01 / BUSINESS DETAILS

Business Details

Tell us about your company so we can set up the right account

02 / YOUR CONTACTS

Your Contacts

Let us know who to contact about your account and services.

Primary Contact

Secondary Contact — Optional

Designated Employer Representative — Optional

03 / SERVICES & BILLING

Services & Billing

Choose the services your team needs. You can select more than one.

Physicals

Drug Tests

Breath Alcohol Tests

Respirator Testing

Other Testing

Lab-Based Testing

Immunizations & Vaccines

Workers’ Compensation

04 / RESULTS REPORTING

Results Reporting

List everyone who needs access to your organization’s exam and test results.

Authorized Contact 1

Authorized To View — Select All That Apply

Authorized Contact 2

Authorized To View — Select All That Apply

Authorized Contact 3

Authorized To View — Select All That Apply
05 / PAYMENT TERMS

Payment Terms

Review the payment terms and complete your acknowledgement.

Payment Terms

Payment is due at time of service or within 30 days of the invoice date.

Late Payment

Please ensure payments are made in a timely manner to avoid any disruption to your account, such as being placed on “Results Hold” or “Credit Card Only” status. Late penalties may also be applied. Accounts with outstanding balances that remain unpaid may be sent to collections if payment cannot be obtained.

Acknowledgement And Agreement

By signing below, I acknowledge that I have read and agree to the payment terms listed above. We appreciate your business and look forward to working with you.

If you select Yes, an OHC team member will contact you to arrange secure collection of your card-on-file information. Please do not enter card details in this form.
06 / REVIEW & SUBMIT

Review & Submit

Please review your information before submitting your account setup request.

Thank you! Your submission has been received!
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