Get Employer Based Wellness Program Commitment Agreement

Filling out the Employer Based Wellness Program Commitment Agreement is a vital step in promoting workplace wellness. This guide will walk you through each section of the form, ensuring a smooth online completion process.

Follow the steps to successfully complete the agreement online.

1. Press the ‘Get Form’ button to access the Employer Based Wellness Program Commitment Agreement and open it in your preferred editor.
2. Begin by completing Part A, which requires your employer information. Enter the organization name, organization ID, and the name of the organization's head or contracting authority. Make sure to provide the complete mailing address, including the city, state, and ZIP code.
3. Next, move to the Commitment Agreement section. Review the statement carefully, as it outlines your commitment to supporting and implementing a worksite wellness program. Acknowledge the importance of fostering a healthy, supportive work culture by encouraging open communication and teamwork among employees.
4. In this section, you will also need to sign your name as the head or contracting authority of your agency or subdivision. If applicable, take a moment to date your signature to ensure the form is current.
5. Proceed to Part C to provide the wellness coordinator's contact information. Fill in the appointed wellness coordinator's name, telephone number, and email address. Additionally, complete the mailing address, including the city, state, and ZIP code.
6. After filling out all sections of the form, take a moment to review your entries for accuracy. Once confirmed, save any changes made, and choose to download, print, or share the completed form as needed.

Complete the Employer Based Wellness Program Commitment Agreement online today to support workplace wellness.