District 47 – Wellness Screening Registration Form


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Bernotas screening is on 03-19-2020 from 6AM to 9AM
Canterbury Elementary School screening is on 3-04-2020 from 6:30AM to 9AM
CORE Center screening is on 3-10-2020 from 6:30AM to 9AM
Coventry Elementary screening is on 3-11-2020 from 6:30AM to 9AM
Glacier Ridge & Wedhe Center screening is on 3-16-2020 from 6:30AM to 9AM
Hannah Beardsley screening is on 3-02-2020 from 6AM to 9AM
Husmann Elementary screening is on 3-06-2020 from 6:30AM to 9AM
Indian Prairie Elementary screening is on 3-20-2020 from 6:30AM to 9AM
Lundahl screening is on 3-03-2020 from 6:00AM to 9AM
North Elementary screening is on 3-17-2020 from 6:30AM to 9AM
South Elementary screening is on 3-05-2020 from 6:30AM to 9AM
West Elementary screening is on 3-12-2020 from 6:30AM to 9AM
Woods Creek Elementary screening is on 3-09-2020 from 6:30AM to 9AM
Your insurance status will be validated before the screening.

Tests Requested

Please check each additional test below you would like to add to your basic screening
Note: Basic screening includes: CMP, CBC, & Lipid Panel
Note: Additional lab tests may also be added or changed, the day of your screening

All screenings include, height, weight, blood pressure, and body composition analysis

Click here for lab test explanations

Total charges: $
Total pre-paid charges: $
After payment, please click 'Return to Community Health Works' to schedule an appointment

Please remember to fast for 8 hours. Black coffee, water, and plain tea are allowed.
Once you click submit Community Health Works
will contact you to schedule an appointment.

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