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EG USD USE ONLY: 2014-15 WELLNESS REBATE CERTIFICATION FORM For Employee s with WESTERN HEALTH ADVANTAGE (WHA) Medical Coverage (Payment Authorization and Wellness Consultation Information) The employee
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What is wellness rebate certification form?
The wellness rebate certification form is a document that individuals or organizations fill out to certify their eligibility for a wellness rebate.
Who is required to file wellness rebate certification form?
Employees or participants who want to receive a wellness rebate are required to file the wellness rebate certification form.
How to fill out wellness rebate certification form?
To fill out the wellness rebate certification form, individuals must provide their personal information, complete the required sections, and certify their eligibility for the rebate.
What is the purpose of wellness rebate certification form?
The purpose of the wellness rebate certification form is to verify that individuals meet the eligibility criteria for receiving a wellness rebate.
What information must be reported on wellness rebate certification form?
The wellness rebate certification form typically requires individuals to report personal information, participation in wellness activities, and any other relevant details.
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