Office Use Only: ECHO ID Number: Data Entry Date/Staff Results Mailed: Date: Staff Biometrics Screening Results Primary Care Provider Form Banner Health allows eligible members to submit biometrics.
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How to fill out the Banner Health Biometrics online
Filling out the Banner Health Biometrics form online is an essential step for eligible members to submit their biometrics screening results. This guide provides a detailed walkthrough to ensure that you complete the form accurately and efficiently.
Follow the steps to successfully complete the form
- Use the ‘Get Form’ button to access the Banner Health Biometrics form and open it for filling out.
- Begin with Part I, which is to be completed by the eligible member. Ensure you provide your first and last name exactly as it appears on your payroll stub or medical ID card.
- Indicate your relation to the employee (self, spouse, or domestic partner) and fill in the required identification numbers if applicable, such as Lawson ID or medical ID.
- Carefully fill out your personal information, including last name, first name, gender, middle initial, date of birth, phone number, and email address. All fields marked with an asterisk (*) are mandatory.
- Answer the provided health questions accurately, ensuring not to include any personal genetic information or family medical history.
- In Part II, the health care provider will complete their section of the form. This includes noting down lab tests ordered, the screening date, and required health measurements such as height, weight, blood pressure, and more.
- Before submitting, ensure that both parts of the form are complete and that all required signatures are obtained from your health care provider.
- Once all sections are complete, save your changes, then choose to download a copy, print it, or share the form as necessary.
Complete your Banner Health Biometrics form online today to participate and be eligible for wellness incentives.
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