Request Appointment
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Multicare Quarterly Patient Newsletter


Request an Appointment

This form should be used for scheduling Occupational Health appointments only. After submitting the form, please allow at least 24 hours for our Scheduling Department to contact you and confirm your appointment request.

Company:
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Reply To:
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Phone:
(required)
First Name:
(required)
Last Name:
(required)
Physical Exam Postion:
(required)
(required)
Preferred week day for appointment:
Preferred time for appointment:
Drug Screening:

Reason for Testing:
Appointment Location:
Enter any general comments/questions in the space below:
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Fridley Medical Center
(763) 785-4500
Mon-Fri 8am-8pm
Sat 8am-12:00 noon
Blaine Medical Center
(763) 785-4200
Mon-Fri 8am-8pm
Roseville Medical Center
(763) 785-4300
Mon, Wed, Thurs 8am-8pm
Tues, Fri 8am-5pm
Fridley Medical Center Blaine Medical Center Roseville Medical Center