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 from the EAPWebcast Admin.

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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: There is a difference between being alone and experiencing loneliness.

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* 10. TRUE or FALSE: Being more virtual, mobile and a hurried busy culture are all modern day contributors to loneliness.

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* 11. TRUE or FALSE: Building your connectivity by working from the inside out, creating connections and practicing savvy social skills are all steps toward tackling loneliness.

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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.
Choose File
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