PARAMEDICAL EXAM FORM

*ALL FIELDS ARE REQUIRED*

A&M PHLEBOTOMY SERVICES

ABOUT YOUR UPCOMING APPOINTMENT

"Paramedical Exam"

 From the comfort of your home or office a highly-trained examiner will inquire about medical history, measure height, weight, blood pressure and pulse. Blood and urine specimens may also be collected. In some instances a electrocardiogram (ECG) may be done. The entire exam is approximately 30 minutes. 

"Do I need to fast?"

 You may be required to fast for a minimum of six to eight hours depending upon the requirements of the insurance company. That means no food or beverages except water. Advise your examiner if you have previously had problems when having your blood drawn such as fainting, nausea, difficulty with clotting or if you bruise easily. 

"Things to do the day of my exam?"

LIST ANY ILLNESSES OR PAST INJURIES 

  • all details, including dates of treatment.

DOCTORS AND MEDICAL FACILITIES

  • Compile a list of your doctors names,  last appointment dates, and a list of medications you are taking. 

APPROVED LABORATORY COMPANIES

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APPROVED INSURANCE COMPANIES

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