Get Questphysician Fax Standard Screening Formstate Of Iowanew Hires Only101615xlsx - Das Iowa

Filling out the QUESTPhysician Fax Standard Screening Form is essential for new hires in Iowa to ensure proper health screening and benefit eligibility. This guide provides detailed instructions on completing the form accurately and efficiently.

Follow the steps to fill out the form correctly and submit it.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred document editor.
2. Begin with Section 1, labeled 'Participant Information.' Clearly print your details, including your date of birth, gender, name, address, email, and phone number. If applicable, indicate your status as an employee, spouse, or dependent.
3. Review the disclosure statement thoroughly. Acknowledge your understanding of how your health screening data will be utilized and ensure it is accurately signed and dated.
4. Proceed to Section 2, which is reserved for the health care provider. Ensure that your health care provider fills out the required body measurements and biometrics results accurately.
5. Confirm that the health care provider certifies the biometric values as correct. This includes verifying the facility name, provider's name, phone number, date of service/test, and obtaining necessary signatures.
6. After completing the form, ensure all sections are filled out legibly and correctly to avoid any invalidation.
7. Finally, save your changes, and if necessary, download, print, or share the completed form as required.

Complete your documentation online to ensure your participation in health screenings and benefit eligibility.