Greetings from Your Doctor's Office,

You are receiving this email because you are scheduled for your Medicare Annual Wellness Visit soon. Your doctor asks that you complete the

following Wellness Survey before you arrive to ensure your time with them is thorough but expeditious.

Since your doctor will make care recommendations based on your responses, please be as detailed and complete as possible. The survey will

take about 10 minutes to fill out. Press Submit after answering the last question. You will have the option to print your responses for your records.

Instructions

• Visit: - Blue Marble Annual Wellness Visit Survey Page
• User the credentials: - (Ask your doctor for them.)
• Username: - ___________________________
• Password: - ___________________________
• Press Submit
• Answer - Answer all the questions thoroughly and to the best of your knowledge
• After answering all the questions - Press Submit

On the day of your doctor's visit...

• Bring: any supporting paperwork:
• Power of Attorney
• Living Will

Thank you for your participation!