Deadline to Enroll is June 1 - Weight Watchers Series (June 2016 through Sept. 2016)

Weight Watchers Registration & Payment Options

Members of the Crouse family are invited to participate in this series and can attend onsite or community-based meetings. Meetings at Crouse Hospital are held on Wednesday's at noon (Conference Room A, 1 Memorial). Participants can also attend community based meetings and must register through this program to be eligible for incentives. Note: there is a group of Crouse employees who attend meetings on Saturday mornings in Dewitt.

Simply Well Membership Cost Reimbursement Incentive
Incentives distributed as Visa Gift Cards. Weight at Weeks 8 and 17 will be compared to Initial weigh-in. Maintenance Weight will be compared to Week 17 weigh-in.

Week 8 Reimbursement - earn $20 for at least 5% weight loss

Week 17 Reimbursement - earn $20 for at least 5% overall weight loss and $40 for at least 10% overall weight loss (provided in addition to reimbursement earned at Week 8)

Maintenance Reimbursement (maintain Week 17 Weight for six months, within 2 pounds)

Participants with 5% overall weight loss as of Week 17 receive an additional $20
Participants with 10% overall weight loss as of Week 17 receive an additional $40

Maximum Reimbursement is $60 for 5% weight loss/maintenance and $100 for 10% weight loss/maintenance.

Question Title

* 1. Please enter your information.

First Name

Last Name

Crouse Employee #

Email address

Phone number

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* 2. I plan to attend the majority of meetings in the below setting:

Onsite at Crouse (Wednesday's at noon in Conference Room A)

Community

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* 3. Payment method

Payroll Deduction for $186 (single paycheck)

Payroll Deduction for $186 (three consecutive paychecks)

Pay with credit/debit card at first meeting

Pay with a check at first meeting

I am already paying a monthly pass in the community