Get Generic Biometric Screening Form
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the Generic Biometric Screening Form online
The Generic Biometric Screening Form is an essential document used to gather important health information for individuals participating in wellness programs. Completing this form online streamlines the process, ensuring that your health data is accurately recorded and submitted with ease.
Follow the steps to complete the Generic Biometric Screening Form online:
- Press the ‘Get Form’ button to access the Generic Biometric Screening Form and open it in your preferred editor.
- In Section 1, complete the patient information. Fill out the patient's date of birth in MM/DD/YYYY format, include the employee ID number, and select the gender by marking the appropriate box.
- Enter the patient's first and last name along with their unit or apartment number, street address, city, state, and zip code.
- Provide the patient's phone number formatted with dashes. Finally, enter the date, and ensure the patient signs the designated area.
- In Section 2, which is for the health care provider's use, the provider needs to input biometric measurements. Fill in the height, weight, waist circumference, blood pressure, pulse, and BMI.
- For laboratory results, include fasting glucose levels, triglycerides, total cholesterol, HDL, and LDL values. It is necessary to certify that the listed biometric values are accurate by providing the date of service or test.
- Enter the facility name, health care provider's name, and phone number. The provider must sign the form and provide the date.
- After completing the form, you can save the changes, download, print, or share the completed Generic Biometric Screening Form.
Complete your Generic Biometric Screening Form online today to ensure efficient submission of your health information.
When do you get the results? Some or all of the biometric screening results will be available to you within a few minutes. If your blood sample is sent to a laboratory, blood results may take a week or longer. The results will be sent to you by mail or electronically, depending on which you request.
Fill Generic Biometric Screening Form
The 2025 Physician Screening Form is a form that your physician can complete with biometric results from your next well-being visit or annual physical exam. No information is available for this page. The blank forms are generic and not specific to your program. Section 2 – Employee Instructions. Take this form with you to your appointment.
Industry-leading security and compliance
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.