Onsite Health Services and Program Registration

Yes I am interested in having a health promotion program coordinated at my worksite.  A minimum of 20 employees is required. For more information call 703-208-5622.

Contact Information
Company Name

Industry
Street Address
City

State
Zip
Phone

Fax
Contact Person

E-mail
Title
Preferred Method of Contact Phone
Mail
E-mail
Participants
Total Number of Employees
 Estimated Number of Participants
Payment Method
Employer
Employee
Co-pay
Program Date and Time
Please indicate when your company is planning this event.
First Choice
Start time End time
Second Choice
Start time End time
Onsite Health Services

Check all that apply.

Total cholesterol and HDL Vision screening
Full lipid profile (fasting required) Head, neck and shoulder massage
Glucose screening Body fat screening
Blood pressure screening "Ask the dietitian" booth
Osteoporosis screening Hepatitis screening (3 part series)
Foot screening Tuberculosis testing (PPD)
Skin screening Random drug testing
Hearing evaluation Physical examination

Onsite Health Lectures

List topic/subject 

Additional Comments

You will be contacted within 10 business days to confirm your request.
Thank you for allowing Inova the opportunity to keep your employees healthy. Please allow us a minimum of three to four weeks to plan your program.