Get Physician Results Form To Update 8.17.12 - Alief...

Filling out the Physician Results Form To Update 8.17.12 - Alief... online can be a straightforward process if you follow the appropriate steps. This guide will provide you with clear, detailed instructions to ensure that each section of the form is completed accurately.

Follow the steps to successfully complete the form online.

1. Press the ‘Get Form’ button to access the form and open it in the designated online editor.
2. Enter the wellness participant's information, including their name in the format Last, First, Middle Initial and their email address. Ensure that the date of birth is formatted as MM/DD/YYYY, and provide the employee ID, phone number, and complete address details including city, state, and zip code.
3. The wellness participant must sign and date the form to authorize the submission.
4. In the section for the physician's office, input the date of testing. Ensure that all testing and measurements were conducted within the specified dates between 9/1/2012 and 4/15/2013.
5. For the biometric screening measurements, fill in the required fields: height in inches and feet, blood pressure readings (systolic and diastolic), weight, glucose level, total cholesterol, triglycerides, LDL cholesterol, and HDL cholesterol. For any result that is not available for reporting, enter 'NG'.
6. The physician or their designee must sign and print their name on the form. Include the date, UPIN/NPI, and phone number for their office.
7. Review all the information entered in the form for accuracy before submitting.
8. Alternatively, save changes, download, print, or share the form if required.

Complete the Physician Results Form online today to ensure timely processing of your health screening.