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WELLNESS QUESTIONNAIRE USE OF THIS FORM IS MANDATORY: NO SUBSTITUTIONS WILL BE ACCEPTED Dear Doctor or Health Care Provider: My employer is sponsoring a wellness program and has hired a company to
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Provider please sign this is a document that requires a provider to sign in order to confirm information or agree to terms.
Providers or individuals authorized to act on behalf of the provider are usually required to file provider please sign this.
To fill out provider please sign this, the provider needs to read through the document, sign where indicated, and provide any required information.
The purpose of provider please sign this is to ensure that the provider acknowledges and agrees to the information or terms presented in the document.
The specific information required to be reported on provider please sign this can vary depending on the document, but typically includes the provider's name, contact information, and signature.
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