Forms for Clients - Land Sea & Air Medical Review

Forms for Clients

Vouchers

DOT pdf format (Adobe required)
DOT standard format
Non DOT pdf format (Adobe required)
Non DOT standard format
Standard pdf format (Adobe required)
Standard standard format

Recently hired employee list
pdf format (Adobe required)
standard format
Terminated employee list
pdf format (Adobe required)
standard format

Company Update Form
pdf format (Adobe required)
standard format
Billing Information Form
pdf format (Adobe required)
standard format
LSA Services Form
(online form)
OSHA Forms
(PDF format)

If you do not have Adobe Acrobat Reader or need to upgrade to the newest version, please click below:

Please make sure you are utilizing the most recent Medical Exam Certificate as well as the current Medical Exam Report. These forms are substantially different from the previous forms.

If you or your company needs to order these current forms, please contact JJ Keller & Associates, Inc. at (800) 327-6868 or visit their website at www.jjkeller.com. Thank you!

REMINDER: All companies participating in random drug and alcohol screenings must provide Land, Sea & Air with quarterly updates of all safety sensitive employees.
You must provide this listing on the first of January, April, July and October.
This list can be faxed to (631) 225-3064 or mailed to 910 Route 109, N. Lindenhurst, NY 11757. Companies that fail to provide these updates may be out of compliance with DOT regulations.
Non-compliance on a DOT audit can have serious repercussions. Please call our office for further information.