Paramedical Exam Request

If you would like to request a Paramedical Exam from IPE Screening, please complete the form below.

Once we receive your request, we will use the Applicant Name and Phone Number to schedule a date and time for the exam.

Applicant






MaleFemale
SmokerNon-Smoker

Policy
Term LifeWhole/UL LifeDisability


VitalsBloodUrine/HOSParamedEKGHIV ConsentSenior SupplementMD ExamTreadmill EKGSaliva

Agent