Health Risk Assessment Form for your Annual Wellness Visit

Are you 65 or older and have Medicare?  To help make your Annual Wellness Visit easier, take some time to fill out a Health Risk Assessment Form.  This form will provide questions about problems and concerns that are important risks to your health.  Just click on the link below, answer all questions, and print the results to take with you to your Annual Wellness Visit.  This will take less than 10 minutes of your time.

Medicare Health Risk Assessment Form

SMA Locations

Springfield, Massachusetts

Phone: 413-739-5676
Fax: 413-733-5860
Toll Free: 1-800-541-8374

Enfield, Connecticut

Phone: 860-741-6058
Fax: 413-733-5860

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