2026 Lab Pre-Registration Form

Valley County Health System 2025 Health Fair : Rev Up For Wellness

6:00 - 9:30 a.m.VCHS, 2707 L Street, Ord Thursday, June 11, 2026

Name

First NameMiddle InitialLast Name

Date of Birth

Date

Gender

Street or PO BOX

City

State

Zip

Phone

Format: (000) 000-0000.

Email

example@example.com

The following lab tests are offered during the VCHS Health Fair. Please indicate which tests you would like performed.

Health Screen $35

Comprehensive Metabolic Panel and Total Lipid Profile (Cholesterol, Triglyceride, HDL, and LDL) This screening measures total cholesterol, glucose, and chemical imbalances of the kidney, liver, and heart. TSH for Thyroid Screen This test is used to detect problems affecting the thyroid gland. Thyroid gland is an essential organ responsible for producing hormones that help control the body's metabolism. Complete Blood Count This test gives a variety of information about the kind of cells in the body, including red blood cells, white blood cells, and platelets.

HBA1C for Diabetes Screen $20

PSA $15

Protime $10

Fasting is necessary prior to the blood chemistry draw, including caffeine or decaf coffee. You may drink water. Break- fast will be served, so you may eat after your blood is drawn. Results will be mailed to participants within a week to the address provided. Test fees cover the cost of screening supplies. Fees will be collected when at the Health Fair. Insurance doesn't cover these tests.

Questions? Contact VCHS PR/Marketing Manager Megan Johnson at 308.728.4356 or mjohnson@vchsne.org