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Employee Tobacco Attestation Form Effective for Plan Year January 1, 2018, December 31, 2018, Campbell wishes to promote healthy lifestyle choices for its employees, and does so in part by using healthcare
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How to fill out employee tobacco attestation form
How to fill out employee tobacco attestation form
01
Step 1: Obtain a copy of the employee tobacco attestation form.
02
Step 2: Fill in the employee's personal information, including their name, employee ID, and contact details.
03
Step 3: Answer the questions related to the employee's tobacco use. Provide accurate information about their smoking habits, including the frequency and duration.
04
Step 4: If the employee is a tobacco user, indicate whether they are interested in receiving assistance to quit smoking.
05
Step 5: Review the completed form for any errors or missing information.
06
Step 6: Sign and date the form to certify its accuracy.
07
Step 7: Submit the completed form to the appropriate department or supervisor.
Who needs employee tobacco attestation form?
01
The employee tobacco attestation form is needed by employers to collect information about their employees' tobacco use. It may be required by the company's health and wellness program or as part of compliance with workplace policies.
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What is employee tobacco attestation form?
Employee tobacco attestation form is a document that employees may be required to complete to disclose their tobacco use status.
Who is required to file employee tobacco attestation form?
Employees who are asked to complete the form by their employer are required to file employee tobacco attestation form.
How to fill out employee tobacco attestation form?
Employees are typically required to provide their personal information, tobacco use status, and sign the form to certify its accuracy.
What is the purpose of employee tobacco attestation form?
The purpose of the form is for employers to gather information about their employees' tobacco use status for health and wellness purposes.
What information must be reported on employee tobacco attestation form?
Employees must report their tobacco use status and provide any additional information requested by the employer on the form.
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