Health screening registration for Employees

Full Name as per NRIC/Work Pass*

NRIC/FIN

Mobile Number*

Email

Date of Birth*

Company Name

Screening Location: [email protected] (National Library @ Bugis) Level 3

Pay on Site: Cash, Credit Card and Pay Now

Special Pricing for Employees and Dependants.
Click here to view the Preferential Rates for you!

Choose your Health Screening Package (Fasting Required)*

Screening Date*

Preferred Health Screening Time (Subject to availability, alternatives will be provided if selected timing is unavailable)*

Please choose one imaging test for your package (Conducted at Raffles Place)

ULTRASOUND KIDNEY

ULTRASOUND BREAST

ULTRASOUND THYROID

ULTRASOUND LIVER

ULTRASOUND PANCREAS

Onsite Addons - Conducted during health screening
RETINA SCREENING - S$60
cPass - S$56
Heart Screen - Apolipoprotein A | Apolipoprotein B | Apo B/A1 Ratio | HsCRP - S$80
Deficiency Screen - Vitamin D | Vitamin B12 | Folic Acid | Iron - S$120
HCV Antibody - Hepatitis C Antibody - S$40
H Pylori Antibody - Helicobacter Pylori - S$44
Testosterone - S$30

Onsite Addons - Conducted during health screening
RETINA SCREENING - S$60
cPass - S$56
Heart Screen - Apolipoprotein A | Apolipoprotein B | Apo B/A1 Ratio - S$55
Deficiency Screen - Vitamin D | Vitamin B12 | Folic Acid | Iron - S$120
HCV Antibody - Hepatitis C Antibody - S$40
H Pylori Antibody - Helicobacter Pylori - S$44
Testosterone - S$30

Imaging Services to sign up for (Conducted at Novena or Paragon)
ULTRASOUND HEPATOBILIARY SYSTEM (pancreas, liver, gallbladder, spleen and bile duct)- $194.40
ULTRASOUND ABDOMEN (INCLUDING liver, gallbladder, spleen, pancreas, and kidneys- $253.80
ULTRASOUND KIDNEYS- $135
ULTRASOUND THYROID - $140.40
ULTRASOUND PELVIS (TRANSABDOMINAL) - $151.20
ULTRASOUND PELVIS (TRANSVAGINAL)) - $199.80
ULTRASOUND PROSTATE - $216
ULTRASOUND BREAST- $140.40
ULTRASOUND KUB (KIDNEYS & BLADDER) - $194.40
MAMMOGRAM - $237.60
MAMMOGRAM & ULTRASOUND BREAST - $302.40
BONE MINERAL DENSITY (DEXA) - $133.92

As part of the health screening procedure and to ease waiting time on screening day, we seek your help in providing the below information.

Race - arrange in alphabetical order*

Chinese

Eurasian

Indian

Malay

Gender*

Male

Female

Do you smoke?*

Yes

No

Do you drink Alcohol?*

Yes

No

if Yes, how often do you drink? An alcoholic drink is defined as a can (330 ml) of regular beer, half a glass (100 ml) of wine or 1 nip (30 ml) of spirit.

How often you exercise per week?*

I lead a sedentary lifestyle

Once a week

2-3 times a week

More than 3 times weekly

Have you had health screening before?*

Yes

No

If Yes, when was the last screening

Do you have any Dietary restrictions or plans?*

Yes

No

If Yes, Please elaborate

Are you on regular medication?*

Yes

No

If Yes, Please elaborate

Are you on regular supplements?*

Yes

No

If Yes, Please elaborate

Do you have a history of any of the following?*
Diabetes
High Blood Pressure
Gastrointestinal conditions
High Cholesterol
Heart Diseases eg: Stroke or heart attacks
Cancer
Asthma
None
Others

Please Elaborate if you have any history of the above:

Does your family have a history of any of the following?*
Diabetes
High Blood Pressure
Gastrointestinal conditions
High Cholesterol
Heart Diseases eg: Stroke or heart attacks
Cancer
Asthma
None
Others

Please Elaborate if you have any history of the above:

Please Elaborate if you had surgical history:

Consent*
I hereby authorise, agree and consent to allow 7 Vision Pte. Ltd. to:
collect, use, disclose and/or process personal data about me that I had provided 7 Vision Pte Ltd, that I now provide 7 Vision Pte Ltd, that I may in future provide 7 Vision Pte Ltd for all purposes pertaining to health screening and in cases of any medical emergencies.

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