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Get Biometric Form 2020-2025
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Open form follow the instructions
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Easily sign the form with your finger
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How to fill out the Biometric Form online
Filling out the Biometric Form online is a straightforward process that helps ensure your health screening information is accurately submitted. This guide provides a step-by-step approach to assist users in successfully completing the form.
Follow the steps to fill out the Biometric Form accurately
- Click the ‘Get Form’ button to obtain the Biometric Form and open it in the editing interface.
- In Section 1, fill in your member information. Enter your date of birth, first name, middle initial, last name, medical ID number, and daytime contact phone number. Indicate your status by selecting either 'Spouse/Domestic Partner' or 'Employee'.
- In Section 2, select between Option A or Option B. If you choose Option A, ensure that you have entered all necessary lab values into Section 3 and acknowledge that you will fax your lab slip alongside the form. If you select Option B, your healthcare provider will fill out the required details.
- In Section 3, complete the body measurements and biometric results fields. Enter your height, weight, fasting glucose, blood pressure readings (systolic and diastolic), and cholesterol levels (HDL, LDL, and total). Be sure to provide the screening date, ensuring it is after 11/15/2012.
- If applicable, proceed to Section 4 to input your provider information. Fill in the facility name, provider's name, phone number, and obtain the provider's signature. This step is only necessary if you are not submitting actual lab documents.
- In Section 5, provide your signature by entering your name along with the date of signature. This indicates your consent for your data to be shared with your health plan or program administrator.
- Once all sections are complete, save your changes. You may choose to download, print, or share the filled-out form as needed. If necessary, fax it to Vivacity at 425-918-5075 or toll-free at 1-877-657-4183, or email it to wcif@vivacity.net.
Start completing your documents online to ensure your health screening is processed without delay.
Related links form
Filling out a Canada biometric consent form follows similar steps to US forms. Start by entering your personal details and ensure you understand the consents you are providing. Carefully review the form for accuracy, then sign and date it. For help, platforms like uslegalforms offer templates and guidance.
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