Get Catapult Health Primary Care Provider Form V2

Filling out the Catapult Health Primary Care Provider Form V2 online is a straightforward process. This guide will help you navigate each section of the form, ensuring that you provide all necessary information accurately and promptly.

Follow the steps to complete the form efficiently.

1. Click ‘Get Form’ button to access the document and open it in your preferred digital editor.
2. Begin by filling in your personal details in the 'Patient Authorization and Release' section. This includes your first name, middle initial, and last name, as well as your date of birth. Ensure that your information is written clearly to avoid any delays.
3. Provide your employee's name and employee ID if applicable. Make sure that the names match those used in your employee records.
4. Fill out your phone number for any follow-up communication regarding your form submission.
5. In the 'Provider Instructions' section, your primary care provider will need to complete the necessary fields. This includes their name, signature, and the date of tests performed.
6. The provider will also need to enter specific health metrics, such as total cholesterol levels, HDL cholesterol, triglycerides, LDL cholesterol, glucose, A1C, blood pressure, height (in feet and inches), and weight (in pounds). This data may be important for meeting the physical requirement.
7. The provider should indicate whether you fasted prior to the tests by selecting 'YES' or 'NO'.
8. Once all necessary fields are completed and checked for accuracy, save the changes to your form.
9. Finally, choose your preferred method for submitting the form to Catapult Health. You may mail it to the specified address or send it via fax, ensuring that it reaches Catapult Health before the deadline.

Complete the Catapult Health Primary Care Provider Form V2 online to ensure your physical requirement is met seamlessly.