Determining Eligibility

If you have not yet had an exam under the WTC Worker & Volunteer Medical Screening Program but think you may be eligible, call the Registration Hotline at (888) 702-0630. Alternatively, you may print and fill out a copy of the eligibility form and fax or mail it to us.

Contact Information Update Form

If your contact information (name, address, telephone numbers) has changed since you had your initial exam under the WTC Worker & Volunteer Medical Screening Program, it is extremely important that you update us if your contact information (name, address, telephone numbers) changes. Please print and fill out a contact information update form and fax or mail it to us.

On that form you will see that we would also like you to provide us with the contact information of at least two people (such as family members) who are not living in the same household as you and who will always know how to contact you. This information will be kept in the strictest confidence and they will never be contacted for any purpose other than in our efforts to get in touch with you.

Exam Location Change Form

Please complete an exam location change form, if you wish, to change your preferred exam location. If you want to continue to be seen at the same clinic, you do not need to complete one of these forms.

Agreement to Receive Messages Containing Protected Health Information

By law, we need your permission before we can leave a message containing "Protected Health Information" (such as exam appointment time) on an answering machine, with someone who answers your phone, or at a particular telephone number. It is helpful for us to have your permission to do this, if you are comfortable with us having this authority, please print, complete and fax or mail the form to us.