Fax the completed form to the confidential Quest Diagnostics fax number on the form. Confirm your form was successfully faxed to Quest Diagnostics at 844-560-5221. 1. Quest will not accept forms after January 10, 2014. x Physician Results Form option is available for those participants who cannot participate at an on-site event or Patient Service Center. Results received after this date will not be accepted. Complete the registration form and verify all your personal information. All required form fields must be completed. Quest Diagnostics will be our biometric screening vendor. How to access and print the Physician Results Form NEW for 2019 On your Rewards page, under Wellness Visit, click on Physician Results Form. The individual (or authorized person) must sign and date a consent form that includes: • Statement of test purpose and description • Statement that prior to testing, the physician ordering the test discussed with the Go to your secure Quest Diagnostics portal to review and save your demographic information. At Quest Diagnostics, we complete over 3.5 million biometric screenings every year, through on-site biometric screenings, physician results forms for screening with a primary care physician, as well as at-home collection options which can include advanced tests like hemoglobin A1c. Uploading a Physician Form Only Physician forms can be uploaded to the Quest portal. Already upgraded but still having issues? Use black ink and write legibly. You are . If your form is received after 9/15/2012, your results will not be processed for medical eligibility. Step 2: You will then review and accept the terms and conditions two times. If you have multiple forms for members of your household, they must be faxed separately. Your physician may fax the form for you. Step 1: You will need to create an account if you do not already have one using SOT as the Registration Key. Be sure to check the Communication Preferences box, so you can stay up-to-date on the processing of your PRF and data. Physician Results Form – Sending the form to Quest After your doctor completes the form, there are three options for submitting the form to Quest. Click Save to continue. Confirm your form was successfully faxed to Quest Diagnostics at . • Your doctor can fax the completed form to the fax number indicated on the form, or Quest will receive Lab and CVS results directly and automatically send those to your healthcare company. You are responsible for ensuring your doctor returns this form by 12/15/2018. Quest Diagnostics staff will not confirm receipt of your form so keep a copy of your fax confirmation statement. Step 3 On the next page, select “Download Form” to access and print your form. Screenings completed at the JPMC Health & Wellness Centers will be faxed to Quest by the H&WC staff. Results received after this date will not be accepted. responsible for ensuring your doctor returns this form by . By submitting this form, you are requesting your physician to report laboratory and biometric results to Quest Diagnostics for your Health Risk Screening. Go to My.Questforhealth.com to download the physician screening form or to schedule an onsite screening. Provider Completes” section of the form. consent to the physician ordering germline genetic testing and/or releasing test results. For each associate only one fully completed physician form can be submitted in 2012 Physician results cannot be combined with or used to override any actual measured results by Quest … Contact Us at 1-844-346-9580.