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Section B Biometric Screening Results Body Measures Systolic Height Diastolic inches lbs Waist mmHg Clinical Laboratory Fasting Blood Glucose LDL Cholesterol mg/dL Triglycerides National Provider ID or CLIA Number meet Vitality s healthy range standards you may complete and submit the Biometrics Physician Waiver or if you are currently pregnant the Prenatal Care Veri cation Waiver. This waiver is valid for the remainder of your current program year. Section A Member s Information First Name...
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Vitality forms on concordiaplansorg are forms used to report vital information related to Concordia Plans.
Employers and individuals affiliated with Concordia Plans are required to file vitality forms.
Vitality forms on concordiaplansorg can be filled out online by logging into the Concordia Plans portal.
The purpose of vitality forms on concordiaplansorg is to ensure accurate reporting of information for Concordia Plans members.
Vital information such as enrollment details, dependent information, and coverage information must be reported on vitality forms.
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