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WELLNESS Screening form Access to the Employer Reimbursement Funds is dependent on receipt of a Wellness Confirmation within 60 days of effective date of insurance coverage. Have your physician complete
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Who needs wellness screening form?

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Wellness screening forms are typically required by individuals who are participating in a specific program or event that necessitates monitoring of their health condition.
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- Athletes competing in sports events
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The exact requirements may vary depending on the specific organization or institution.
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A wellness screening form is a document used to collect health-related information from individuals to assess their overall health and well-being, including factors such as medical history, lifestyle choices, and potential health risks.
Typically, employees participating in certain wellness programs or insurance plans are required to file a wellness screening form as part of their health assessments.
To fill out a wellness screening form, individuals should provide accurate personal information, complete any required health questionnaires, and may need to supply biometric data such as height, weight, and blood pressure if applicable.
The purpose of a wellness screening form is to identify health risks, promote preventive care, and encourage individuals to engage in healthier lifestyles, ultimately reducing healthcare costs and improving community health.
The form typically requires personal information, medical history, current health status, lifestyle choices (such as diet and exercise), and any relevant biometric data like cholesterol levels and blood sugar.
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