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N ati v e A m e r ica n s f o r C o mm un ity A ct i o n , I n c.

Test results Native Americans for Community Action. N ati v e A m e r ica n s f o r C o mm un ity A ct i o n , I n c. M A IN O FFICE: 27 1 7 N . St e v e s Bl v d ., S u ite 1 1 Fl a g s t a f f , A ri z on a 8 6 0 04 - 0 7 08 F AX : ( 9 28 ) 5 26 - 0 7 08

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N ati v e A m e r ica n s f o r C o mm un ity A ct i o n , I n c.

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  1. Test results Native Americans for Community Action Native Americans forCommunity Action, Inc. MAIN OFFICE: 2717N.Steves Blvd.,Suite11 Flagstaff,Arizona86004-0708 FAX: (928) 526-0708 Phone: (928) 526-2968 FAMILY HEALTH CENTER 1500E.Cedar Ave.,Suite26 Flagstaff,Arizona 86004 FAX: (928) 773-9429 Phone: (928) 773-1245 Name: DOB: DateofScreening:Yourscreening results are as follows: Do you use tobacco? Yesor No Do you want to stop using tobacco? Yesor No Can NACAreferyou toASH line-for tobacco cessation? Yesor No Pleaseutilizethis information to followup withyourdoctororprimarycareprovider for furthertesting or information. Feel freetocontact us foranyquestions regarding this letter. Thankyou, NACA Health Promotion Team 928-773-1245, ext. 32

  2. **Follow-up testingwith primarycareprovider office should bedone if valuesout-of-range. Blood Glucose (“bloodsugar”) Blo od Pre ssu re Blood Cholesterol ** This information is to serveas a screening tool and nota diagnostictool.

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