To receive credit towards the 2021-22 Healthy Actions Medical Plan. Please complete this form and upload your certificate awarded to you for completing the Wellness Webinar.

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* 1. First Name

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* 2. Last Name

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* 3. Date of Completed Training

Date

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* 4. Employee ID Payroll Number

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* 6. E-mail Address

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* 9. TRUE or FALSE: Live well strategies, for those living with a chronic illness, include remembering your strength, imaging a bright future, taking time for humor, joy and gratitude, and recharging.

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* 10. TRUE or FALSE: Having a chronic condition or caring for someone who has a chronic condition can have an emotional, physical, social and productive toll on their lives.

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* 11. TRUE or FALSE: It is important to care for your body when living with a chronic condition by checking your basic needs (sleep and nutrition), managing your medication and releasing tension (mindfulness and relaxation).

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* 12. Please upload the certificate of attendance you received via e-mail from the Cigna Employee Assistance Program (EAP). Only PDF, DOC, DOCX, PNG, JPG, JPEG, GIF files are supported.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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