Get the free Physician BMI Release Form - Alere

Instructions to complete Physician s Attestation Last year s Health Risk Assessment and biometric values provided a picture of your overall health. The results will help you set priorities for maintaining

How to fill out physician bmi release form

How to Fill Out Physician BMI Release Form:

1. Obtain the form: Contact your physician or healthcare provider to request a copy of the BMI release form. They can usually provide you with a physical or digital copy of the form.
2. Read the instructions: Before filling out the form, carefully read the instructions provided. Familiarize yourself with the purpose and requirements of the form to ensure you provide accurate information.
3. Personal information: Start by entering your personal details in the appropriate sections of the form. This typically includes your full name, date of birth, address, contact information, and any relevant identification numbers, such as your social security number or patient ID.
4. Medical history: Next, provide information about your medical history. This may include any underlying health conditions, previous surgeries, allergies, medications you are currently taking, or any other medical information that may be relevant to your BMI assessment.
5. Authorization: In this section, you will usually need to sign and date the form to authorize the release of your BMI results to the specified individuals or organizations. Make sure to read this section carefully and understand the terms of authorization before signing.
6. Healthcare provider information: If the BMI release form requires your healthcare provider's information, ensure you accurately fill in their name, contact details, and any other required information. This helps to ensure that your BMI results are sent to the correct recipient.

Who Needs Physician BMI Release Form:

1. Typically, individuals who have undergone a medical examination or have sought professional healthcare advice for weight-related concerns may need to fill out a physician BMI release form. This form allows the healthcare provider to release the BMI results to the individual or to other specified parties, such as insurance companies, employers, or referring physicians.
2. Additionally, individuals participating in weight management programs or wellness initiatives may be required to provide a physician BMI release form to track their progress or eligibility for certain services.
3. It is essential to consult with your healthcare provider or the organization requesting the form to determine whether it is necessary in your specific situation. They can guide you on when and how to complete the form accurately and provide any additional information or requirements that may be needed.

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