Get Lghib Lg12 2022-2025

The LGHIB LG12 form is a crucial document for participants in the Local Government Health Insurance Board Wellness Program, outlining necessary health screenings and personal information. This guide will provide detailed instructions on how to effectively fill out this form online.

Follow the steps to complete the LGHIB LG12 form online.

1. Click ‘Get Form’ button to obtain the LGHIB LG12 form and open it in the editing interface.
2. Fill out Section 1, which must be completed by the participant. Enter your name, insurance number, group number, age, date of birth, and last four digits of your Social Security Number. Additionally, indicate if you are male or female, and provide a daytime phone number and email address.
3. In Section 1, mark all applicable boxes for any medical conditions you have or have been informed you have, such as high cholesterol, high blood pressure, or diabetes. Also, mark whether you take medication for these conditions.
4. Proceed to Section 2, which is to be completed by the healthcare provider. Ensure your provider fills out the required lab results, including blood pressure, total cholesterol, HDL, LDL, triglycerides, blood glucose, height, weight, and BMI.
5. Once the form is completed, review all entries for accuracy to ensure no fields are left incomplete, as forms submitted with missing information will not be processed.
6. Save any changes made to the form. You may also choose to download, print, or share the completed form as necessary.

Complete your LGHIB LG12 form online today to participate in the wellness program and take charge of your health.