Employer Resources
Akeso Clinical Excellence Solution (ACES)
Employer Portal
Information
ACES Employer Portal Fact Sheet
Employer forms
Use these forms to authorize treatment of an injured or sick employee as well as to open an account with your clinic and establish a payment method.
Please email forms to customercare@akesomedical.com
Chula Vista / National City
Forms
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Commerce
Forms
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
El Centro Clinic
Forms
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Huntington Beach Clinic
Forms
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Irvine Clinic
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Lakewood Clinic
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
La Mirada Clinic
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Mission Valley Clinic
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Napa Clinic
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
National City Clinic
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Oceanside Clinic
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Oxnard Clinic
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Paramount Clinic
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Riverside Clinic
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Santa Fe Springs North Clinic
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Santa Fe Springs South Clinic
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Santa Maria Clinic
Forms
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
TREATMENT AUTHORIZATION-PRV
Autorización para tratar
TREATMENT AUTHORIZATION-PRV
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Templeton Clinic
Forms
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Thousand Oaks Clinic
Forms
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
Vista Clinic
Forms
TREATMENT
AUTHORIZATION
Autorización para tratar
TREATMENT
AUTHORIZATION
Fill out /Print
EMPLOYER
QUESTIONAIRE
Cuestionario de empleo
EMPLOYER
QUESTIONAIRE
Fill out /Print
CREDIT CARD
AUTHORIZATION
Autorización de crédito
CREDIT CARD
AUTHORIZATION
Fill out /Print
Workplace Notices
IN CASE of INJURY
WALL SIGN
IN CASE of INJURY
WALL SIGN
Fill out /Print
For more information, please contact us at info@akesomedical.com