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YOU MUST PROVIDE A RESULT FOR EACH SCREENING BELOW IN ORDER TO RECEIVE CREDIT FOR THIS YEAR S REQUIREMENTS SCREENING RESULTS Blood Pressure Systolic Total Cholesterol Low Density Lipoprotein LDL Height in inches High Density Lipoprotein HDL Waist Circumference Triglycerides Weight in pounds T. Cholesterol / HDL Ratio BMI Body Mass Index Glucose Pulse Heart Rate PHYSICIAN I certify that the patient listed above received the tests indicated on this form on Month Day Year Name/Signature of...
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What is wellworksforyou physician results form?
The wellworksforyou physician results form is a document used to report the results of a physician's evaluation.
Who is required to file wellworksforyou physician results form?
Physicians who have conducted evaluations as part of the program are required to file the wellworksforyou physician results form.
How to fill out wellworksforyou physician results form?
To fill out the wellworksforyou physician results form, physicians need to provide detailed information about the evaluation they conducted.
What is the purpose of wellworksforyou physician results form?
The purpose of the wellworksforyou physician results form is to document the results of physician evaluations for the program.
What information must be reported on wellworksforyou physician results form?
Physicians must report details of the evaluation conducted, including findings, recommendations, and any follow-up plans.
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