State of South Dakota Annual Exam with Blood Work and Biometric Screening Form Submission

Thank you for participating in LiveWellSD. For the primary policyholder to earn the $500 reward, the employee and covered spouse must each complete an annual wellness exam with bloodwork and submission of the Biometric Screening Form and the online Health Assessment. For more information about rewards, go to the Rewards tile under the State of SD tab.

 Complete and submit Biometric Screening Form prior to 4/1/2024.

Schedule your annual wellness exam with blood work. Use the Biometric Screening Form to show your primary care provider what blood work will need to be completed. The form must be completed with your provider and all results entered.  You and your provider need to sign the form at the end of your exam. Follow the instructions on the form and submit it to Total Wellness prior to 4/1/24. It is highly recommended to submit prior to March 1. This allows time for processing and will allow you to check your overall completion status at http://bhr.sd.gov/livewellsd prior to the 4/1/24 reward deadline.

Click the ‘download’ button below to  download the  2023-24 Biometric Screening Form.

The preferred method for submitting your completed Biometric Screening Form is to securely upload by clicking the button below.  Upload only one form at a time.

Within 48 hours of form submission, a confirmation email will be sent to the email address you provided. If a confirmation email is not received within 48 hours, please resubmit your form.  Please allow 10 business days for your information to be available in your LiveWellSD account.

Before submitting your form, check that all fields are completed, and the form is signed by you and your provider.