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Signup for labs at Benefits Fair on 11.3 at SPRIMO terminal

This form will hold your spot in the limited time slots available at the benefits fair on November 3rd from 9am-1pm. If you are at risk for a metabolic health condition you are welcome to take part in these free labs. The labs are taken by machines that only need a finger prick of blood to test.

Sign up for A1c and Lipid testing at SPRIMO on November 3rd

Name(Required)
Which are you?(Required)

Please fill out the below questions so we can determine whether you would benefit from knowing your A1c or lipid lab values.
Have you ever been diagnosed with diabetes, pre-diabetes, gestational diabetes or Non-alcoholic fatty liver disease?(Required)
Have you ever been diagnosed with non-alcoholic fatty liver disease?(Required)
Have you ever been diagnosed with high blood pressure?(Required)
Are you overweight?(Required)
What is your age?(Required)
Are you physically active less than 3 times per week or active less than 150 minutes per week?(Required)
Do you have a parent, brother, or sister with diabetes or pre-diabetes?(Required)
Are you African American, Hispanic, or American Indian?(Required)
Based off of the answers above, you are at risk for diabetes, high blood pressure, or stroke/heart attack, and may benefit from knowing your A1c number. Please select which labs you would like tested(Required)
Please select a window of time on November 3rd to get your blood tested for the A1c/lipid panel(Required)

The Driver's Health and Fitness staff members agree to keep all confidential information, including PHI, in strict confidence.
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2740 N Mayfair Ave, Springfield, MO, 65803

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