The offsite biometric screening form is used for those who are unable to attend an onsite screening and/or choose to submit results obtained by a physician.

Completed form is due on or before October 31, 2019. Date of test must be on or after April 1, 2019.

Before you submit your form, make sure you have:

To submit your form, complete the fields below. Click browse to load your document, then click submit.


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 Date Format: YYYY-MM-DD
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CHG Healthcare is committed to helping you achieve your best health.  If it is unreasonably difficult or medically inadvisable for you to participate in the biometric screening due to a medical condition, you might qualify for an opportunity to earn the same reward by different means. For more information, please contact US Wellness at 1-866-926-6099 x900.