Physician Medical Clearance Portal
Designed for referring medical professionals to review the assessment clearance requirements and return signed documentation through a secure workflow.
1. Download and complete the form
Download the physician clearance PDF, specify applicable restrictions, sign, and scan the completed document.
2. Submit signed clearance
Use the secure Wix Forms submission page linked below to send one completed, signed medical-clearance document. Only authorized personnel should access submitted forms.
Open medical clearance submission form ↗
Submit only the signed clearance and information required by the form. Do not use ordinary email, Calendly notes, or general contact forms to send clinical records. Form submissions are handled through Wix Forms on the PHI-protected site; review permission and the complete workflow must be managed in your Wix account.
3. Clearance review statuses
Submitted documents can be reviewed within the Wix Forms submissions dashboard. Pending, Received, Needs Clarification, and Approved for Assessment are planned administrative statuses; they are not yet automated or synchronized with this form. Review remains assessment-specific, including restrictions and contraindications.
For the laboratory administrator
Review submissions in your authenticated Wix Forms dashboard. Configure minimum-necessary administrator permissions, auditability, and safe download/printing procedures before routine patient use. The custom status tracker is not yet implemented.