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: Everyone experiences depression through causes, triggers and symptoms, differently

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* 10. TRUE or FALSE: Different personal factors of genetics, psychological states, situational experiences and physical factors can contribute to depression.

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* 11. What are obstacles that people experiencing depression face when getting help? Select all that apply.

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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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