Everyone can do their share for better health. 

The Preventative Exam form is only to be used by employees who are not enrolled on District Health insurance, and spouses on Nebo Health insurance.  It is no longer required for employees enrolled on District Health insurance.  Here is how it works:

Employee eligible for Nebo District insurance but not enrolled:  Completes the Preventative Exam requirement for My Share Wellness Prize ($50 gift card, Fit watch, or Wellness Day).  This will include "dependent dual employees".  

Employees not eligible for Nebo health insurance:  Complete this form and return to the Wellness Office at the District Office to receive a $35 gift card. To qualify:  Must work at least 2 hours a day.  Retirees, employees under 18, seasonal and substitutes not eligible.

Spouses on District Health Insurance:  Complete this form and return to the Wellness Office at the District Office to receive a $35 gift card.  All other spouses are NOT eligible for the $35 gift card. 

 

Preventative Exam form 

 There are five requirements to complete or be current (up to date) on the following:

  1. Complete a physical examination from a physician based on age, gender and risk factors.
  2. Complete physician recommended preventative cancer screenings based on age, gender, and genetic risk factors. i.e. mammogram, pap smear, colonoscopy, etc.
  3. Complete a blood chemistry panel within the last 2 years.  More frequent if physician recommends based on risk factors.   Screened items are:  Glucose levels, LDL cholesterol, total cholesterol, and triglycerides.  Patient should receive this information.  
  4. Discuss immunization status.
  5. Discuss recommendations to address present risk factors.  These recommendations should include any prudent professional interventions (i.e. prescriptions) and lifestyle changes (activity and dietary changes).    

Return the signed Employer’s copy of the Preventative Exam form the "Wellness Office" or John Allan at the District Office via IMC, mail or hand delivery.  Copies, images and facsimiles are accepted.   Email: john.allan@nebo.edu  Fax: 801-342-8023.