Get Hmsa Biometric Screening

This guide provides clear, step-by-step instructions on completing the Hmsa Biometric Screening form online. By filling out this form accurately, you can help assess your health status and take important steps toward improving your well-being.

Follow the steps to complete the Hmsa Biometric Screening online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Complete the Participant Information section. Print your first and last name, and select the appropriate gender option. Enter your date of birth, preferred phone number, and email address. In the medical history field, indicate any relevant conditions.
3. Review your responses for accuracy to ensure that all information is correct.
4. Read the Wellness Program Notice and Consent statement thoroughly.
5. Print all pages of the form and ensure that you sign and date where indicated. Remember, the form cannot be processed without your signature.
6. Submit the form to your physician, who will complete the Biometric Measurements and Physician Information sections.
7. The physician will enter biometric measurements and blood test results in the respective fields, including dates of any lab tests done within the past twelve months.
8. The physician must also input their information, including name, medical license number, and telephone number, and sign and date the form.
9. Once everything is completed, review the form to ensure no fields are left incomplete.
10. Submit the completed Physician Screening Form via secure fax to HMSA Well-Being Connection at 877-245-0333. Print the fax confirmation and keep it for your records.

Start the process now by completing your online Hmsa Biometric Screening form.