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HEALTHY WEIGHT VERIFICATION FORM **All information will remain confidential**NAME___ PHONE #___ EMAIL___ *This will count for 2 wellness points if your BMI is over 27 and you lose 10 or more pounds.

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How to fill out healthy weight verification form

01

Obtain a copy of the healthy weight verification form from your healthcare provider or employer.

02

Fill out your personal information accurately, including your name, date of birth, and contact information.

03

Provide information about your height and weight, as well as any additional measurements requested on the form.

04

Have your healthcare provider fill out the verification section, confirming that the information provided is accurate.

05

Submit the completed form to the appropriate party, such as your employer or insurance company.

Who needs healthy weight verification form?

01

Individuals who are required to provide proof of their healthy weight status for reasons such as insurance discounts, workplace wellness programs, or participation in certain activities.

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What is healthy weight verification form?

The healthy weight verification form is a document used to certify that a student meets the required healthy weight standards as outlined by certain health policies or regulations.

Who is required to file healthy weight verification form?

Typically, parents or guardians of students who are subject to health assessments or requirements set forth by educational or health authorities are required to file the healthy weight verification form.

How to fill out healthy weight verification form?

To fill out the healthy weight verification form, you need to provide the student's personal information, record their height and weight, and have a healthcare provider complete the certification section.

What is the purpose of healthy weight verification form?

The purpose of the healthy weight verification form is to ensure that students maintain a healthy weight and receive appropriate support if they are outside of the healthy weight range.

What information must be reported on healthy weight verification form?

The information that must be reported on the healthy weight verification form includes the student's name, date of birth, height, weight, and a signature from a licensed healthcare professional.

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