District 47 – Wellness Screening Registration Form

district47

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Bernotas Middle School screening is on the following:

Tue 03-23-2021 6:00am - 9:00am
Tue 04-06-2021 6:00am - 9:00am

Canterbury Elementary School screening is on Tue 03-02-2021 6:30am - 9:00am
CORE Center screening is on Thu 03-11-2021 6:30am - 9:00am
Coventry Elementary School screening is on the following:

Thu 03-25-2021 6:30am - 9:00am
Fri 04-09-2021 6:30am - 9:00am

Fetzner Operations Center screening is on Wed 03-17-2021 6:30am - 8:00am
Glacier Ridge Elementary School screening is on the following:

Wed 03-03-2021 6:30am - 9:00am
Fri 03-05-2021 6:30am - 9:00am

Hannah Beardsley Middle School screening is on the following:

Fri 03-26-2021 6:00am - 9:00am
Wed 04-07-2021 6:00am - 9:00am

Husmann Elementary School screening is on Tue 03-16-2021 6:30am - 9:00am
Indian Prairie Elementary School screening is on Fri 03-19-2021 6:30am - 9:00am
Lundahl Middle School screening is on the following:

Tue 03-09-2021 6:00am - 9:00am
Wed 03-10-2021 6:00am - 9:00am

North Elementary School screening is on Wed 03-24-2021 6:30am - 9:00am
South Elementary School screening is on Thu 03-18-2021 6:30am - 9:00am
West Elementary School screening is on the following:

Fri 03-12-2021 6:30am - 9:00am
Thu 04-08-2021 6:30am - 9:00am

Woods Creek Elementary School screening is on Thu 03-04-2021 6:30am - 9:00am
Legal First Name
Legal Last Name
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 please wait for the appointment scheduling form to appear...

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