Employer Forms for WellNow Urgent Care
W-9 Forms for MI and IN
Medical Insurance W-9
(This will be used for Workers' Compensation Carriers and Medical Insurances purposes for patients treated at any of our Michigan or Indiana WellNow locations.)
Occupational Medicine Employer W-9
(This will be used for any companies whose employees received Occupational Medicine services at any of our Michigan or Indiana WellNow locations.)
W-9 Forms for NY and IL
Medical Insurance W-9
(This will be used for any Workers' Compensation Carriers and Medical Insurance purposes for patients treated at any of our New York or Illinois WellNow locations.)
Occupational Medicine Employer W-9
(This will be used for any companies whose employees received Occupational Medicine services at any of our New York or Illinois WellNow locations.)
No-fault Insurance for NY Patients
New York is a no-fault insurance state and patients must sign a no-fault form to assign benefits to the provider.
dba WellNow Urgent Care
P.O. BOX 1848
Albany, NY 12201-1848