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Medical Forms

How to Turn In Forms

If participants wish to receive points for medical exams, they will need to upload medical verifications in WellSteps. Acceptable forms of proof include a doctor's note, explanation of benefits, or a signed Healthy Lifestyles Medical Form. We do NOT accept a screenshot of the appointment reminder or medical record (this should be kept private). 

The preferred method is to upload your document directly in WellSteps. However, you can submit proof in any of the following ways:

  • Email: Scanned and emailed to MyHealthyLifestyles@slco.org. You can also take a picture of your form or EOB on your phone and email it directly. 
  • Courier: Attn-Healthy Lifestyles, GC S2-600-4575
  • Drop Box: Located outside the Healthy Lifestyles office Government Center (S3-840)
  • Fax: 385.468.4096

*Remember your forms must be turned in a minimum of 14 days before your scheduled biometric screening. 

Medical Exam Points: 

Medical Exams Points
Mammogram or Prostate Exam 50
Colonoscopy  50
Annual Physical/Pap Test 25
Dental Exam  25
Flu Vaccine 25
Prenatal Exam 25
Eye Exam 25

 

Other:


Healthy Lifestyles
2001 S. State Street S3-840
Salt Lake City, UT 84190
Phone: (385) 468 - 4062
Email: myhealthylifestyles@slco.org