Get Physician Results Report Form - Alere Health

This guide provides clear instructions for users on how to correctly fill out the Physician Results Report Form for Alere Health online. Follow the steps carefully to ensure accurate submission and inclusion in your employer's wellness program.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the form, allowing it to open in your editor.
2. In the ‘Participant Information’ section, enter the participant’s name (last, first, middle initial), unique ID consisting of the last four digits of the social security number followed by the eight-digit date of birth, and date of birth in MM/DD/YYYY format. Include a contact phone number if necessary.
3. Proceed to the ‘My Biometric Screening Results’ section. The primary care physician will fill out the biometric values. Ensure the physician includes the date of measurement for each entry.
4. The following biometric values need to be reported: systolic and diastolic blood pressure, glucose level, total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. Indicate whether the fasting status was YES or NO.
5. The physician must complete their information by providing their signature, printed name, the date, and UPIN/NPI number to validate the form.
6. Once the form is fully completed, the physician's office should fax the document to Quest Diagnostics or return it to the participant to fax it to (610) 271 - 6713.
7. After faxing, ensure to keep a copy for personal records. Confirm with the Quest Diagnostics contact center at (866) 908-9440 if needed.

Complete your Physician Results Report Form online today to take advantage of your employer's wellness program.