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Little Clinic Voucher - Personnel - scrstaff

Little Clinic Voucher - Personnel - scrstaff 2025

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The document outlines the requirements and procedures for using a voucher from The Little Clinic for HumanaVitality members. It specifies the necessary patient information, screening services provided, and the importance of presenting the voucher along with identification and insurance cards. The document emphasizes that eligible participants will not incur costs for specified health screenings and provides details about The Little Clinic's services, locations, and operational hours.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your Patient Name in the designated field. Ensure that it matches the name on your Humana Insurance or HumanaVitality membership card.
Next, fill in your Humana Insurance or HumanaVitality Group ID and Member ID in the respective fields.
Complete the Body Mass Index section by providing your height and weight. This is crucial for accurate health assessments.
Indicate whether you have completed Cholesterol and Glucose screenings, as well as your Waist Circumference measurements.
Record individual patient results for Pulse, Blood Pressure, and any other relevant health metrics.
Review all entered information for accuracy before saving or printing the voucher for your visit to The Little Clinic.

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Versions	Form popularity	Fillable & printable
2015	4.1 Satisfied (46 Votes)
2014	4.1 Satisfied (65 Votes)
2013	4 Satisfied (39 Votes)

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