Get Oh Healthspan Health Screen Form 2012-2026

The OH HealthSpan Health Screen Form is essential for participating in health evaluations and obtaining benefits from your health plan. This guide will provide clear, step-by-step instructions on how to complete the form online effectively.

Follow the steps to complete the OH HealthSpan Health Screen Form online.

1. Press the ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in your last name and first name in the designated fields.
3. Enter your date of birth in the specified format.
4. Provide your age and middle initial in the corresponding fields.
5. Enter your gender by selecting the appropriate option.
6. Input your BHP Card Subscriber ID number in the designated space.
7. Fill in your phone number and email address accurately.
8. Choose one of the two options for biometric data submission and fill out the Physician Name and Address if applicable.
9. Complete the Biometrics/Clinical Lab Values section, including blood screening date and fasting information.
10. Enter your clinical measures, including height, weight, blood pressure, and pulse rate.
11. Indicate your tobacco use status by selecting the appropriate box.
12. Report the number of days you participate in moderate exercise per week.
13. Read and agree to the HIPAA consideration notice, sign and date the form.
14. Once you have completed the form, save your changes, download, print, or share it as needed for submission.

Complete your OH HealthSpan Health Screen Form online today to ensure you can receive your health evaluation benefits.