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Trilogy Health Services Onsite Wellness Program Health Screening Release of Liability, Notice, and Consent First Name:Last Name:Email:Date of Birth Phone Number: I acknowledge that my participation

How to fill out go365tm activity completion form

How to fill out go365tm activity completion form

1. Start by downloading the Go365TM activity completion form from the official website or request it from your Go365TM representative.
2. Fill out your personal information on the top section of the form, including your name, member ID, and contact information.
3. Indicate the activity you have completed by selecting the corresponding checkbox or filling in the required information.
4. Provide any additional details or comments regarding the activity in the designated space.
5. If applicable, attach any supporting documentation or evidence of completing the activity, such as receipts, pictures, or completion certificates.
6. Review the completed form to ensure accuracy and completeness.
7. Sign and date the form to certify that all the information provided is true and accurate.
8. Submit the filled out Go365TM activity completion form through the preferred method specified by your Go365TM representative.

Who needs go365tm activity completion form?

1. Anyone who is participating in the Go365TM program and wishes to receive credit for completing a specific activity needs the Go365TM activity completion form.
2. It is especially relevant for individuals who are required to document their participation in certain activities to earn rewards, incentives, or maintain the eligibility criteria of their health insurance or employer-sponsored wellness program.

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What is go365tm activity completion form?

The go365tm activity completion form is a document that individuals use to report their completed wellness activities to the go365 program, which encourages healthy living and rewards participants.

Who is required to file go365tm activity completion form?

Participants enrolled in the go365 program who have completed eligible wellness activities are required to file the go365tm activity completion form.

How to fill out go365tm activity completion form?

To fill out the go365tm activity completion form, participants should provide their personal details, the specific activities completed, the dates of completion, and any necessary documentation or proof related to those activities.

What is the purpose of go365tm activity completion form?

The purpose of the go365tm activity completion form is to track and verify the completion of wellness activities, which are necessary for earning rewards and incentives within the go365 program.

What information must be reported on go365tm activity completion form?

Participants must report their name, go365 member ID, the activities completed, dates of completion, and any supporting documentation or verification for each activity.