Welcome to the Kiwanis Club of Warren's
2004 Blood Screening Program Sign-Up Form
On-Line registrations will be accepted through
March 28, 2004
This year's screening will be held on
SATURDAY, APRIL 24
BEATY WARREN MIDDLE SCHOOL
6 AM TO 10 AM
For your convenience, the following is a registration form for this years blood screening program. Please indicate your
preference to any of the 16 fifteen minute time slots below. We will
verify the specific time you are scheduled via a confirming
post card which you will receive 10 days prior to the screening.
Blood samples will be drawn and analyzed for 30 separate characteristics.
Warren General Hospital will be performing all lab evaluations.
The base cost of the screening is $ 30 per person.
Prostate screening may be added for an additional $ 25 per person.
NOTE: This test is generally recommended for males 40 years old or older.
Payment may be made by cash or check, payable to "Kiwanis Club of Warren"
upon your arrival on April 24.
FASTING FOR THE 12 HOURS PRIOR TO YOUR TEST TIME IS REQUIRED !
CONSUMPTION OF WATER, BLACK COFFEE OR PLAIN TEA IS PERMITTED.