Forms

Use the forms below to submit for credits against health insurance. Keep in mind that all forms are "editable" and information can be typed directly into the form. Fax forms to 888.422.0106 or email them to LiveWell@TeamHealth.com.

For more information on incentives, click here.

Exercise Tracking - Second Quarter, 2012

Tobacco Cessation Prescription Reimbursement

Weight Loss Program Reimbursement

Weight Loss Program Goal Completion

Health Coaching Application

BMI Reduction