Below, you will find a preview of the required Medical Examiner Report Form MCSA-5875. This is the standard form used for general certifications. It is required that the patient complete Section 1. After completion, provide the forms and certificate to your employer.
If you are insulin dependent, there is a separate form that is required. This form can be found at the following link:
INSULIN DEPENDENT MCSA-5870 FORM
WE WILL BE CLOSED 05/24 and 05/26 in observance of Memorial Day!
NOW offering in-office Semaglutide and Tirzepatide injections for weight loss as well as body sculpting with EMSCULPT NEO and Exion, RF Microneedling and incontinence treatments with the EMSELLA chair. For cosmetic payment plans and more information check