Patient Information - Fighter Clearance Test
Last Name
First Name
Middle Name
Patient SS
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Sex
M
F
Date of Birth (mm/dd/yyyy)
Address
City
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip
Home Phone
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Draw Site: (IMPORTANT - you will need to make note of the clinic you select.)
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- Select Draw Site -
Tulsa - St. John Medical Center, 1923 S. Utica, 5th Fl. Siegfried Tower, (918) 744-2500
Tulsa - St. John Medical Park, 8131 S. Memorial, Suite 104, (918) 249-0859
Tulsa - Warren Medical Building, 6465 S. Yale, Suite 112, (918) 481-2747
Tulsa - Bernsen Medical Plaza, 1919 S. Wheeling, Suite 100, (918) 744-3295
Tulsa - OSU Physicians Building, 802 S. Jackson, Suite 230, (918) 585-9581
Tulsa - Kelly Medical Building, 6565 S. Yale, Suite 108, (918) 502-4280
Tulsa - Williams Medical Plaza, 2000 S. Wheeling, Suite G101, (918) 744-2858
Tulsa - Hillcrest Physicians Building, 1145 S. Utica, Suite G163, (918) 585-1630
Tulsa - Herman G. Kaiser Medical Building, 1725 E. 19th, Suite 302, (918) 744-2501
Tulsa - Utica Park Clinic, 1245 S. Utica, Ground Level, (918) 579-3762
Bartlesville - Jane Phillips Medical Center, 3500 SE Frank Phillips, 2nd Fl, (918) 331-1775
Bartlesville - Medical Park Center, 3400 SE Frank Phillips, Suite 105, (918) 333-4370
Bartlesville - Physicians Park Plaza, 224 SE DeBell, Su8te 102, (918) 331-1035
Bartlesville - Adams Hills Office Park, 4140 SE Adams Rd, Suite 105, (918) 331-1807
Claremore - Park Medical Plaza, 3100 Medical Parkway, Suite 200, (918) 341-5637
Muskogee - Patient Service Center, 223 N 32nd St., (918) 682-5301
OKC - RML Edgewater Medical Center, 3705 NW 63rd St., Suite 101, (405) 286-9903
OKC - Northwest Service Center, 13301 N Meridian, Building 300B, (405) 751-9980
OKC - Physicians & Surgeons Bldg., 1211 N Shartel, Suite 907, (405) 231-1949
Owasso - Owasso Medical Center, 13600 E 86th St. North, Suite 200, (918) 274-1114
Owasso - St. John Owasso Medical Center, 12451 E 100th St. North, (918) 275-5151
Ponca City - Ponca City Medical Center Specialty Services, 1908 N 14th, First Fl, (580) 762-9129
Sapulpa - St. John Medical Center Sapulpa, 1005 E Bryan, 1st Fl, (918) 224-4280, ext 2230
Pittsburg, KS - Pittsburg Medical Complex, 2401 S Tucker, Suite 5, (620) 232-7765
Independence, KS - Independence Professional Office Suites, 800 W Chestnut, (620) 331-8825