The Lake Cumberland District Health Department has my permission to perform the screening required to complete the Wellness Check. As part of the Heart4Change program I may receive mailings about LCDHD programs based on my results. I understand I may be tested for (HIV) infections, Hepatitis B, or any other disease carried by blood or body fluids if such a test(s) is needed if a health care worker is exposed to my blood, body fluids or tissue. I also acknowledge that I have been read a copy of the LCDHD Notice of Privacy Practices.