Get Healthyroads Biometric Screening Form 2020

Filling out the Healthyroads Biometric Screening Form 2020 online is a straightforward process designed to help eligible members submit their biometric screening results. This guide will provide clear, step-by-step instructions to ensure that you complete the form accurately and efficiently.

Follow the steps to complete the form online.

1. Click ‘Get Form’ button to access the Healthyroads Biometric Screening Form 2020 and open it in the online editor.
2. Begin by filling out Part I of the form. Indicate the reason for submitting the form by selecting either 'Initial Biometrics Screening for this plan year' or 'Reconsideration of Biometrics Screening Results.' Be sure to provide your first and last name exactly as it appears on your payroll stub or medical benefits card.
3. Fill in additional required fields, including your date of birth, phone number, and email address. Ensure all mandatory fields marked with an asterisk (*) are complete.
4. Review the member attestation and authorization statement. If you agree, provide your signature and the date to authorize your physician to report the necessary results.
5. Provide the form to your physician for them to complete Part II. Make sure they fill out all required fields, including the date of screening and results for various measurements such as cholesterol levels and blood pressure.
6. Once your physician has signed and completed the form, save your changes and ensure you have a complete copy for your records.
7. Submit the completed form via fax, secure email, or mail to the provided Healthyroads contact information. Ensure it's submitted before the specified deadline.

Complete your Healthyroads Biometric Screening Form 2020 online today to stay on top of your health.