| Medical Screening: |
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Comprehensive Health History Questionnaire |
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Chest X-Ray: PA, Lateral, Right/Left Oblique |
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Pulmonary Function |
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Vision Screening |
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Hearing Test |
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Resting Cardiogram |
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Vital Signs |
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Blood & Urine Screening, including: Blood Chemistries,
CBC, Urinalysis, Infectious Disease Screens, Cancer Screens,
Heavy Metals Screens, and more… |
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Comprehensive Hands-on Physical Examination (Includes) |
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Annual Respirator Medical Evaluation |
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Fitness For Duty Assessments |
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Medical Referrals |
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Respirator Fit Testing |
| Wellness Programs: |
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Health Risk Appraisal Questionnaire |
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Lifestyle Assessments |
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Biometric Screening |
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Guaiac Stool Screen (Colon Cancer Screening) |
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Trend Analysis |
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Personal Wellness and Health Coaching |
| Annual Fitness Evaluations: |
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Aerobic Capacity – Sub Maximal Stress Test (Gerkin
Protocol) |
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Muscular Endurance & Strength (Arms & Legs) |
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Flexibility Measurements (Shoulder, Trunk, & Legs) |
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Body Fat Composition & BMI |
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Exercise Prescriptions |
| Records Management
and Reporting Services: |
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HIPAA-compliant Reporting |
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Web-based Reporting |
| About Me & My
Company: |
*First
Name: |
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*Last
Name: |
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-Title: |
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*Company: |
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-*Address
1: |
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-Address
2: |
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*City: |
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*State: |
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*Zip: |
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-*Phone#: |
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*Email
Address: |
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| Current
Method Of Health Testing: (Check All That Apply) |
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In-House Program |
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Outside Clinic / Hospital |
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Mobile Van Service, if checked -
Provider:
|
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New Program |
| Comments: |
|
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*
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* Required
Fields |
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