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: Sometimes stress cannot be avoided, but we can learn to recognize it and learn how to respond to it.

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* 10. TRUE or FALSE: Everyone experiences stress and mental health issues the same way.

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* 11. TRUE or FALSE: We can help others who are experiencing emotional distress by (1) recognizing signs of distress, (2) reaching out to connect and (3) providing them with resources for help and support.

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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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