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  • 2026 Biometric Screening Form Submission:

    Upload your completed Biometric Screening Form by 11/30/2026.

    Before you submit your form, please complete the following steps:

    • Print clearly and review your form to ensure it is complete.
    • Date of screening is required. Confirm the date of screening is within the following date range: 12/1/2025-11/30/2026
    • Be sure to provide a valid email address so we can communicate with you regarding the status of your form.
    • Ensure you and your physician have signed your form. Both signatures are required.

     

    2026 Preventative Form Submission:

    Upload your completed Preventative Form by 11/30/2026

    Before you submit your form, please complete the following steps:

    • Print clearly and review your form to ensure it is complete.
    • Date of Exam/Vaccination is required. Confirm the date of exam/vaccination is within the following date range: 12/1/2025-11/30/2026
    • Be sure to provide a valid email address so we can communicate with you regarding the status of your form.
    • Ensure you and your physician have signed your form. Both signatures are required. Your physician signature is required once for each exam type. Example: You completed your Annual Physical Exam & received a flu shot. Your doctor will need to sign on the Annual Physical Exam line and, on the Flu Shot line.







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