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1730 Haines Ave.  •  Rapid City, SD  •  (605) 718-2778
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Black Hills Occupational Medicine Forms

The forms below are the Black Hills Occupational Medicine forms. Please use the forms applicable to your situation.

Occupational Medicine Forms

Release of Information Form

Drug and/or Alcohol Eligible Participants

Service Request Form

CDL (DOT) Physicals

DOT Medical Examinations (effective April 20, 2016)

DOT -CDL Specialty Doc Form

New Requirements for CDL Physicals – effective May 21, 2014

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Rapid City, SD 57701
(605) 718-2778
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