Imagine Your Best Self: Preventive Health Screenings

You can earn $50 per exam, with a maximum of four screenings per year. The Preventive and Biometric Screening Form is used to submit any exam including your biometric screening. The form will include a space for provider performed biometric screening and a space for preventive exams. Individual forms must be submitted for each exam for up to a max of four submissions per program year.

Preventive Exam List:

  • Pap/HPV Test
  • Mammogram
  • Colorectal Cancer Exam
  • PSA Test
  • Skin Exam
  • CT Lung Scan
  • Biometric Screening
  • Primary Care/Annual Wellness Visit
  • Vision Exam
  • Dental Exam
Click to view full (& printable) preventative screenings flier

Where do I go to access the form?

  • Log in to InsideCHI and visit the well-being pages (formerly My Healthy Spirit)
  • Log in to InsideCHI and visit the well-being pages (formerly My Healthy Spirit)
  • Click on “Wellness” and select “Your Wellness Website”
  • Visit the 2018 Program page
  • Select the Preventive Health Screenings section
  • Go to Biometric Screening or Preventive Health Exams to access the appropriate form

How do I submit my completed form for credit?

  • Download the form, bring it with you to your exam/screening and have your provider complete and sign
  • the form
  • Download the form, bring it with you to your exam/screening and have your provider complete and sign the form
  • Scan and save completed form to your computer
  • Log in to Inside CHI and visit the well-being pages (formerly My Healthy Spirit)
  • Click on “Wellness” and select “Your Wellness Website”
  • Visit the 2018 Program page
  • Select the Preventive Health Screenings section
  • Upload form under appropriate exam/screening

How long do I have to submit my form?
You can submit Preventive and Biometric Screening Forms anytime between 1/8/2018 – 9/28/2018.

What if I have my exam after 9/28/2018?
The acceptable exam dates for the 2018 wellness program year are 10/1/2017 – 9/28/2018. Preventive and Biometric Screening Forms submitted after 9/28/2018 are not eligible for the 2018 incentive program. Any preventive and biometric screening exam(s), which occur after 9/28/2018, will be accepted during the 2019 wellness program year.

Can I submit more than one exam on the same form?
A separate form must be submitted for each exam to receive credit.

What if the same provider performs multiple exams during one visit?
Your provider needs to sign a separate form for each eligible preventive exam in order to receive credit. I went to my provider for a preventive exam but I forgot to bring my form. Can I still submit a form to receive credit? Only completed, signed forms will be accepted.

How long after I submit my form will I receive credit on the wellness website?

  • Preventive Exams: Once submitted successfully, you will receive an immediate confirmation of receipt. Your earned wellness dollars will be visible on the Earn page within moments of receiving the confirmation popup and email.
  • Preventive Exams: Once submitted successfully, you will receive an immediate confirmation of receipt. Your earned wellness dollars will be visible on the Earn page within moments of receiving the confirmation popup and email. Biometric Screening: Two business days after receipt of approval confirmation.