Adaptalift Group Medical Service Request Form



All sections must be completed for appointments to be processed.



Requestor Details



Candidate Details


At least one phone number is required


Worksite



Service Details



Candidate Availability



Injurynet will contact the candidate to obtain their availability and location for the medical.

Please select at least 9 hours over a minimum of 2 weekdays. If you would like to add additional days to your selection please click on +.

Injurynet will book the candidate's medical based on the date and times you have provided. Please note, all cancellations and non-attendances will incur a fee.