An Employer’s Guide to Onsite Clinic Care

Tackle rising healthcare costs with onsite clinic care and learn cost-effective strategies for employee well-being.


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An Employer’s Guide to Onsite Clinic Care

A shift is underway in workplaces: Employees no longer have to leave the office for vaccinations, quick check-ups, or prescription refills. Onsite clinics are emerging as a convenient healthcare solution for employees—available even after regular office hours.

Employers are integrating onsite clinics into broader strategies to control overall healthcare costs, enhance employee health and well-being, reduce productivity disruptions, and boost employee satisfaction with their benefits package.

In this guide, you’ll discover more about the utilization of onsite care, the diverse structures of onsite clinics, and key considerations for employers looking to implement this approach in their workplace. 

Chapter 1

Introduction to Onsite Clinic Care

Despite the significant role primary care plays in improving health outcomes, many stakeholders struggle to effectively provide primary care services to the populations they serve.  To begin addressing this challenge, let’s explore the fundamentals of primary care and innovative delivery models.

Introduction to Onsite Clinic Care

The ultimate goal of primary care is to provide accessible, coordinated, high-quality care that improves health outcomes and controls costs. The American Academy of Family Physicians notes that primary care includes disease prevention, health maintenance, counseling, patient education, diagnosis and the treatment of acute and chronic illnesses.

Studies have repeatedly shown that patients who receive primary care experience better health outcomes. In fact, American adults who have routine access to a primary care physician have 19% lower odds of dying prematurely than those who see only a specialist. But as impactful as primary care services are, a 2021 survey found that almost a quarter (24 percent) of respondents had not received any such care in the previous year.  

U.S. adults who regularly see aprimary care physician have
lower odds of dying prematurely than those who see only a specialist

The biggest obstacle to seeking basic care often comes down to something that should be easier to tackle: convenience. Taking time away from work and traveling to a doctor’s office can be overwhelming for some people. But what they fail to see is that as a result of ignoring their health concerns, they may ultimately miss more work, incur costly medical expenses, and be less productive on the job. Because of this dynamic, many healthcare stakeholders are turning to innovative delivery models that can help remove these barriers.  

According to the National Association of Worksite Health Centers (NAWHC), an onsite employer clinic is a “setting where an employer or union offers one or more medical and wellness services, delivered by licensed providers, to all or a designated portion of its active population and other eligible individuals.” Such clinics can be structured in many different ways based on the employer’s goals and the employees’ needs.  

Traditionally, most campuses focus on providing urgent care, resulting in gaps in overall health management. Thus, educational institutions are exploring innovative primary care models to meet the different needs of students and staff while fostering engagement in both populations. Because the structure of onsite clinics can be tailored to the type of end-user, components such as operating hours and service offerings can be targeted in a way to increase usage.

One of the key challenges in rural America is the provision of and access to primary care services. In fact, by 2025, a shortage of more than 20,000 primary care physicians is projected in our nation’s rural areas

“Microclinics” offer a solution to this challenge with a range of services that can be provided, for example, via mobile clinics/physicians or prefabricated facilities in remote towns with populations as small as 500. These clinics extend care to geographic markets previously limited under traditional business models.  

A shortage of more than
primary care physicians is projected in America’s rural areas by 2025

Let’s take a closer look at employer onsite clinics and why they are so effective.  

How Does an Onsite Clinic Impact the Use of Healthcare Services? 

An onsite clinic offers several important benefits for employers and their employees.

According to NAWHC, these include:

  • Convenient Access.

    When services like preventive screenings and immunizations are offered onsite, employees are more likely to seek them. Furthermore, without wasted travel time to and from a physician’s office, absenteeism and productivity loss are reduced.

  • Lowered Costs.

    Emergency and urgent care visits—which are quite costly—decrease. And when chronic conditions are managed early, total costs of care are lowered.

  • Improved Retention.

    Onsite clinics are an investment that businesses make to ensure the well-being of their employees, which can go a long way to attracting and retaining high-quality talent.  

The potential downsides to an onsite clinic should be weighed against these benefits.

According to the Society for Human Resources Management, a few potential downsides of onsite clinics might include: 

  • Administrative Commitment. 

    The cost and administrative burden may be too overwhelming.

  • Staffing. 

    Smaller employers may not have the resources to staff an onsite clinic or help drive engagement.

Fortunately, third-party organizations are available to help with both of those challenges.

What Models of Care Does an Onsite Clinic Provide?

A one-size-fits-all approach will not work for onsite clinics. The most successful approaches will be customized to the employer’s goals and employees’ needs. With that in mind, the range of services offered can greatly vary. For example, the main function of some clinics is to provide basic occupational health and first aid, while others might offer urgent care, mental health services, lab testing, and imaging.  

What Is a Hybrid Approach to Providing Onsite Care?

Not every organization has unused space that can be transformed into a clinic. As a result, some employers use empty storefronts as a “near-site” clinic or they partner with another business and share a clinic. Other settings include mobile clinics adjacent to buildings or even clinic vehicles that visit satellite offices. Another option that increases access and convenience is a hybrid approach. Providing onsite care during work hours along with telehealth services during “off” hours means that employees have access to care around the clock—which ultimately results in less need for costly emergency services. 

Chapter 2

Onsite Clinic Care as an HR Strategy

Recent research has found that health has contributed almost as much to income growth as education. These findings demonstrate that economics is closely tied to the health of a population. With this perspective in mind, more employers are assessing the connection between the physical and mental well-being of their workers and the strength of their business. As a result, employers are incorporating employee health into their overall business strategy.  

Onsite Clinic Care as an HR Strategy


Organizations that prioritize workplace health are motivated by a number of potential outcomes, including: 

Reduced healthcare costs

Reduced healthcare costs.

In simplest terms, the healthier your employees are, the less you will eventually have to spend. Healthy employees are sick and injured less often, which, in turn, leads to lower insurance costs for employees. 

Decreased absenteeism

Decreased absenteeism.

Healthier employees are more productive since they won’t need to miss work due to illness. For example, overweight and obese men miss approximately two more work days per year than normal-weight men, constituting a 56% increase in missed days.

Diminished presenteeism

Diminished presenteeism.

Presenteeism occurs when employees physically report to their jobs, but chronic illness or mental health challenges prevent them from working to their full potential. The Harvard Business Review estimates that presenteeism costs the U.S. economy more than $150 billion a year in lost productivity. 

Improved recruitment and retention

Improved recruitment and retention.

A recent study found employees who felt regularly stressed or tense were three times more likely to seek new job opportunities within the following year. When employers provide workplace health programs, they send the message that they care about their employees’ mental and physical health. 

American workers are considerably less healthy than workers in other countries. In fact,  approximately 80% of employees use few, if any, medical services in a year. How can employers do more to empower their workers to take a more active role in their health and wellness? 

Based on its research, Gartner identified three ways employers can support their employees’ health-related efforts: 

Increase employee understanding of well-being needs and offerings

Increase employee understanding of well-being needs and offerings.

Workers often simply don’t know what help is available to them. Increasing employee awareness of workplace health programs and resources is foundational to empowerment. 

 Reduce well-being stigma and apathy

Reduce well-being stigma and apathy.

Fear or self-consciousness may prevent some employees from seeking the help they need. Managers can play a significant role in helping their direct reports overcome these obstacles.  

Make it easy to participate in well-being programs

Make it easy to participate in well-being programs.

In its report, Gartner noted that, of workers who responded, 38% said they were too busy to take advantage of the benefits their employer offered. Engage workers by integrating well-being activities into the normal routine of the workday. 

It should come as no surprise that benefits top workers’ list of things they value in an employer.  Fortunately, many employers are listening. In a 2023 report, The Business Group on Health (BGH) found that 65% of employers see healthcare as an “integral” part of their workforce strategy. Following are some common questions that employers raise when they examine onsite healthcare as part of their HR efforts.  

of employers see healthcare as an “integral” part of their workforce strategy

How Do Onsite Healthcare Clinics Impact Retention of Employees and Recruitment?

Offering direct-to-employer healthcare gives businesses an edge when it comes to retaining employees. In a 2017 Mercer survey, 83% of employers with onsite healthcare clinics reported high employee satisfaction. The positive impact of direct-to-employer benefits can be felt on the recruitment side as well. According to a Fractl survey of 2,000 workers, 88% of job seekers said that they would give "some consideration" or "heavy consideration" to a lower-paying job with better benefits than a higher-paying job with fewer benefits.  

Can Employer Onsite Clinics Impact Workplace Productivity?

A 2023 MetLife study reports that 60% of employers found that health benefits helped their staff become more productive. In part, this can be attributed to the fact that when workers receive consistent preventive and primary care, they are more likely to be healthier and miss fewer days at work. Furthermore, healthy employees won’t need to shoulder the additional burden of covering for their absent co-workers. And when they do need to seek care, they won’t have to leave the workplace to receive healthcare services. 

How Does an Onsite Clinic Support Your Goal of Having the Best Employee Benefits?

Through direct-to-employer healthcare solutions, organizations can help their workers fulfill the promise primary care offers. Mercer’s 2023 survey found that the most common types of primary care services provided in respondents’ onsite clinics include:

Biometric screenings
Labs and preventive care exams
Behavioral health screenings
Lifestyle coaching

What makes a considerable difference is not just the type of services that are offered but the way those services are delivered. At onsite clinics, staff are solely dedicated to the specific employee population. This personal connection offers a type of consistency that facilitates follow up. For example, in 67% of the clinics in Mercer’s survey, clinic care teams proactively call members to bridge any potential gaps in care.  

An Employer’s Guide to Onsite Clinic Care

Download the PDF version of the guide.

When lost productivity due to sick days, poor job performance, turnover, and burnout are accounted for, the overall cost of preventable illnesses grows considerably. Because of the proximity and consistency they provide, onsite clinics are a valuable tool for controlling those cost variables while improving employee health.  

Is onsite healthcare the right solution for you? Let’s weigh the pros and cons to help decide if it’s the best option. 

According to NAWHC, the benefits of employee health clinics include:   

  • Convenient Access and More Engagement.

    As discussed earlier, when healthcare services are provided in the workplace, employees are more likely to use them. Consistent access to providers at an onsite clinic means that employees’ health can be tracked and monitored over time.  

  • Reduced Cost of Care Per Person.

    A 2020 study assessed the utilization and cost of primary care services that incorporated employer-sponsored onsite, near-site, and virtual primary care. The findings revealed a lower total cost of care per person than that in a traditional model  

  • Improved Employee Retention.

    By meeting employees where they are, businesses that provide onsite healthcare demonstrate that they are committed to the well-being of their employees.  

A few “cons” to onsite clinics that might be considered include:   

  • Clinic Management.

    The administrative burden of operating an onsite clinic may be too overwhelming for smaller companies.  

  • Lack of Privacy.

    The fact that their care is managed at the workplace might worry some employees who fear that their employer can access their medical records. This is an unfounded fear since onsite clinicians only share aggregate data—not patient-specific data—but nonetheless, it must be discussed to ensure employee engagement. 
  • Location.

    Not every organization has the space to host a center within its facility or near the work site.  

Fortunately, most onsite clinic providers can work to alleviate all of the above concerns. 

Chapter 3

Using Onsite Clinic Care to Improve Employee Wellness and Control Total Costs of Care

Healthcare is an expensive benefit for employers. At the same time, workers want more from their employer-sponsored health plans. So, how can organizations reduce benefits expenditures and meet evolving workforce demands?  

Using Onsite Clinic Care to Improve Employee Wellness and Control Total Costs of Care

Role of an Annual Physical Exam in Your Employee Health Strategy

Research shows improved access to primary care services like annual physicals can lower overall healthcare costs. Adults who regularly visit a primary care physician have 33% lower healthcare costs than those who only see a specialist for their care.   

Adults who regularly see a primary care physician have
lower healthcare costs than those who see only a specialist

What Is Direct Primary Care and How Is it Beneficial?

Direct primary care is care provided by clinicians in the workplace, typically in onsite clinics. This type of care can be blended with telehealth services so that employees and their families can access care 24/7. Onsite clinics fulfill many of the qualities employers are seeking in delivering primary care to their employees.

These qualities include:  

Integration of mental health services`

Integration of mental health services.

Since the start of the COVID-19 pandemic, the number of people looking for mental health services has soared. Having easy access to mental health services is more essential than ever for today’s workers. 

Engaging people before they become patients

Engaging people before they become patients.

Regular communication and interactions with primary care clinicians, including during annual physical exams, help patients stay healthy. By providing these opportunities onsite, employers make preventive healthcare visits much more viable for employees.  

A focus on continuous quality

A focus on continuous quality.

Using aggregate, real-time patient data, onsite clinics make it easy to track and respond to, such as quality metrics and patiet experience scores.  

Helping people navigate the healthcare system

Helping people navigate the healthcare system.

Given the complexity of the U.S. healthcare system, primary care clinicians in an onsite clinic can provide support to employees through services such as health and wellness coaching.  

What the Best Corporate Wellness Programs Have in Common

What makes employer health clinics such ideal settings for wellness initiatives? Let’s look at three critical reasons.   


Generally, employees aren’t excited to participate in initiatives that involve additional time outside of work. However, offering wellness programs onsite makes it easier for employees to use them during the workday. Furthermore, offering employees dedicated time to use programs, like brief fitness blocks, during the day—rather than “sequestering” those services for after hours—helps employees feel more satisfied while they’re actually at work.  


Because they rely on claims data from insurers, employers have struggled to identify the specific effects of their wellness initiatives. But the reporting features that many onsite clinics build into their wellness programs can help employers answer important questions, such as:   

  • Has the number of employee sick days decreased since the program was launched?
  • Has workplace stress been reduced? 
  • Has the workforce become less obese? 
  • Has tobacco use among employees declined?  

This information can go a long way toward helping employers adjust their program offerings so that they achieve company goals.   


A recent study found that an important benefit of onsite clinics is that the clinicians who work at them have detailed insight into the culture, setting, and demands of the employing organization. Because onsite clinics use a dedicated, consistent staff, clinicians can develop a connection with patients that lays a strong foundation for wellness coaching. Additionally, reaching lifestyle and health goals—such as weight or stress management—depends on tracking, monitoring, and measuring efforts over time, all of which is possible with consistent staff and regular visits. 

Chapter 4

Must-Knows for Implementing Onsite Clinic Care at Your Company

Rising health insurance expenses and an emphasis on primary care are just two reasons employers are turning to onsite clinics as a delivery mechanism for health services. Providing healthcare at work is a critical way employers can be more proactive about containing healthcare costs—especially those companies with self-funded employer health insurance plans. Let’s look at the business case for onsite care and how self-funded employers are especially suited for this model of healthcare delivery. 

Must-Knows for Implementing Onsite Clinic Care at Your Company

Building a Business Case for Onsite Healthcare

Reason No. 1 Reduced Healthcare Costs

Offering an onsite healthcare option, such as a primary care clinic that serves as a direct primary care provider for employees, allows employers to provide vital preventive and early intervention healthcare services. As discussed earlier, these services can go a long way toward reducing treatment for costly, advanced chronic illnesses and expensive trips to the emergency room, which can ultimately decrease overall healthcare costs for employers. 

Reason No. 2 Improved Employee Productivity and Engagement

Onsite clinics allow employees to manage their healthcare with fewer barriers. This means that workers are more likely to address illnesses promptly before they worsen and, thus, miss less time on the job. According to the Centers for Disease Control and Prevention, employee absenteeism costs employers $225.8 billion annually (or $1,685 per employee) in lost productivity—something to take into serious account when weighing the benefits of onsite clinic implementation. 

Reason No. 3 Lower Turnover and Recruitment Costs

For those in the job market, benefits have always been a compelling component of their search.  Employers who provide perks, such as convenient onsite clinics, show candidates and current staff that their health and wellness are company priorities. As a result, employee engagement and morale improve, which can reduce turnover. Lower turnover rates mean reduced recruitment and training costs, another positive impact on the employer’s bottom line. 

Reason No. 4 Customized Wellness Programs

Ideally, corporate wellness programs create healthier employees who are, therefore, more likely to be present, motivated, and focused on their work. Known as the “employee positivity factor,” this attitude can produce intangible benefits for employers, such as improved customer experience, increased sales, and innovative solutions. Furthermore, wellness programs have been shown to have a positive financial impact on healthcare expenditures. One study found that lower healthcare costs were an associated result of employee participation in a wellness program over a 5-year period. 

Reason No. 5 Actionable Data and Analytics

When employers establish a customized onsite clinic, they can use data to develop an appropriate set of services that will help the employer achieve the best return on investment. Once established, an onsite healthcare program can collect valuable, actionable data. For example, employers can pull metrics about savings that result from employees seeking care at the onsite clinic as opposed to an ER or urgent care center. 

Employer-Sponsored Health Insurance: Self-Funded Plans and Onsite Care

Any type of employer-sponsored coverage can incorporate an onsite clinic. Employers that self-fund (also known as self-insure) their benefits plans will especially benefit. Let’s look at why that is and how employers can achieve their health and cost goals.   

Role of Self-Funded Employer-Sponsored Health Plans  

With self-funded employer-sponsored health plans, employers assume the financial risk of providing benefits to their employees. A business pays its workers’ claims as they occur using money it sets aside monthly instead of paying an insurer one lump sum, as is the case with fully insured plans. At the end of the year, the money accumulated is weighed against claims paid out. For the employer, that difference becomes either savings or an additional expense to cover the overage.  

An increasing number of businesses are choosing the self-funded route for their employer-sponsored health plans. According to the results of a 2022 KFF employer health benefits survey, 65 percent of covered workers surveyed were enrolled in employer self-funded health plans, which is 5 percent higher than in 2012. Is self-funding the right choice for your organization? 

Tips for Getting More out of Employer-Sponsored Health Plans 

As businesses look for ways to control costs while providing high-quality health benefits, many are pursuing self-funded health plans as a way to achieve their goals.

The pros of self-funded plans include the following:   

  • Self-funded plans offer more flexibility because benefits can be customized to the specific needs of their workers.
  • Self-funding can have cost benefits since employers are not subject to state health insurance premium taxes.
  • Self-funded plans give employers control over health plan reserves.  
  • Self-funding allows employers to retain any unused funds that have been set aside for insurance claims.  

Although self-funding offers many important advantages, it may only be right for some organizations. For example, employer-sponsored health plans carry risks because unexpected claims can strain a business’s cash flow. 

How Can Employer Health Clinics Support Self-Funded Plans?

For businesses that self-fund their health benefits plans, supporting patient health at the primary care level is especially critical. When employees don’t use primary and chronic care services, they often incur higher medical expenses for health conditions that could have been either prevented or treated in less intensive settings than an emergency room or urgent care. The result is not only damaging to an employee’s health, but it can also become extremely costly for companies with self-funded health plans. Unexpected, catastrophic claims can strain a business’s cash flow and budgets. To improve access to and use of primary and chronic care services, companies that offer self-funded health insurance are turning to employer clinics as a viable solution

How Can You Bring Onsite Care to Your Workplace?

Do employer health clinics sound like an effective way to stabilize costs while improving employee health? If so, here are a few of the basic steps involved in establishing an onsite clinic for your workers.  

Step 1 Planning

After selecting your onsite care solution provider, your initial discussions should focus on the needs of your specific employee population. For example, would your workers benefit from access to a generic drug plan? Do you have employees with high deductibles for whom access to in-network clinicians is important? The results of these initial discussions will help structure clinical services and their delivery at your clinic. Client site visits will also occur to scout possible clinic space locations.  

Step 2 Working with Health Plans and TPAs

For businesses that self-fund their health benefits plans, clinics do not have a relationship with the health plan because the health plan isn’t paying the clinic. The general belief is that self-funded plans should work with a third-party administrator (TPA) to simplify and streamline the claims process. In addition, TPAs collect important data that can be shared with the employer. In a self-insured plan, claims aren’t being paid by the TPA, but the clinic can still file zero-dollar claims back to the TPA, which allows the TPA to provide important utilization metrics with the employer. 

Step 3 Supporting the Deliverables

Once a clinic is live, the employer’s HR team should develop strategies to continuously engage and encourage employees to use the preventative services available to them onsite. 

Step 4 Measuring Results

To optimize onsite clinic operations, businesses must fully understand what’s working and what isn’t. Monitoring and tracking metrics and goals over time will help employers know how to refine and strengthen their program offerings.   

Chapter 5

Tips for Getting the Most Out of an Onsite Clinic Care Strategy

As discussed, it is well within the reach of any employer to have healthier, happier employees—and an increasing number of employers are striving for that goal. No matter the size of your clinic or employee population, consider the points below as you create a strategy for an onsite healthcare clinic. 

Tips for Getting the Most Out of an Onsite Clinic Care Strategy

Ways to Reduce Healthcare Costs for Employers Using Onsite Clinics

For an onsite clinic to succeed in reducing employer expenditures while improving employee health, employees must be aware of and use the clinic’s offerings. Successful engagement can be achieved in a number of ways. 


The most common incentives employers use include: 

  • Eliminating employees’ co-payments.
  • Reducing the dollar amount of co-payments.  
  • Decreasing employees’ premium contributions.  
  • Offering the clinic as a plan option.  
  • Contributing to employees’ HSA accounts.  
  • Providing cash or gift cards.  

Often, employer health incentive programs are linked to wellness goals that must be reached first, such as obtaining biometric screenings or attending health coach visits.  


Employers should be proactive in emphasizing that each person’s medical information is confidential by law, and none of it will be shared with the employer or other employees. In addition, the location of the health clinic can also impact utilization. Employees are more likely to use services based on the clinic’s accessibility and visibility. 


Just because your clinic is open doesn’t mean employees will visit. Thus, sharing information about the services offered should be an active part of any employer’s engagement strategy. Some examples include raffles for employees who have completed their annual physicals or monthly communication campaigns, such as breast cancer awareness, to attract employees to the clinic.  


Medical professionals who connect with your specific employee population will play a significant role in engaging patients in primary care services. 


When planning for an onsite clinic, seek input from your employees to ensure your program will meet their needs. For example, if your workers view mental health services as an important offering, find out what form they want those services to take. Do they want access to meditation apps, telephone and video appointments, and/or digital self-help tools?    


As pointed out earlier, convivence is a key driver for employee engagement.

Be sure your organization offers: 

  • Walk-ins or online appointment scheduling.  
  • Health information, such as test results and appointment summaries.  
  • Onsite testing for flu, COVID, strep, etc.
  • Onsite blood draws for labs.
  • Messaging opportunities with providers.  
  • Personalized, meaningful action tools and resources.  

Virtual care is just as important in the onsite setting and can be used in place of urgent care during “off” hours.  

Is an Employer Onsite Health Clinic a Fit for Your Business?

Although not all organizations can support onsite clinics, for many employers, they are a realistic and effective option. Consider the following when determining whether your company is a good fit for an onsite clinic. 

Past perceptions

Size: Past perceptions held that only large corporations could afford to offer onsite care.

But that is simply not true. Companies with as few as 150 employees can operate effective and efficient primary care and wellness programs, even if they are offered part-time. In a 2021 survey, among organizations that provide onsite care with fewer than 5,000 employees, 47% offered a shared clinic, compared to just 7% of those with 5,000 or more employees. 

Employee Population

Employee Population: Do your employees neglect primary care, seek treatment at the emergency departments, or have high absentee rates?

An onsite clinic can directly address all of those issues by providing preventive services that are convenient, accessible, and cost-effective.  

Insurance Model

Insurance Model: Fully funded and self-funded insurance models are both able to support onsite care programs.

That said, self-funded models find onsite care especially beneficial because of the high level of risk employers assume. When healthcare is offered in the workplace, employers who self-fund their benefits may experience lowered and more predictable total costs of care. 

Geographic Characteristics

Geographic Characteristics: Location can be a barrier to healthcare access for organizations in remote or rural communities.

A lack of primary care providers in a particular area also creates challenges for employees. However, through onsite programs, employers can extend healthcare access to their employees in markets that lack dependable preventive care services. Some programs offer 24/7 virtual urgent care, which extends coverage to employees regardless of their location. 


It’s Time to Change the Status Quo 

When it comes to employee health and employer costs, it’s clear that the status quo cannot fulfill the potential primary care offers. But as we’ve shown, innovative preventive care and wellness models can capture those missed opportunities.

Onsite, employer-sponsored health and wellness clinics deliver personalized, consistent care that is convenient to use and easy to access. Not only does this mean your employees will be happier and healthier, but your organization can contain healthcare expenditures in a way that has been challenging—if not impossible—in the past. 

If onsite care sounds like an effective way to boost employee health while managing costs for everyone, Hamilton Health Box can recommend onsite care approaches to best meet the needs of your specific population. We provide a unique hybrid approach of in-person and telehealth services that is affordable for companies of all sizes. 

Find out more about how we can help you build an onsite care plan that’s aligned and take control of your healthcare costs. Book a 1:1 meeting today!   

An Employer’s Guide to Onsite Clinic Care

Download the PDF version of the guide.