Employee Wellness Program Participation Consent

I acknowledge that I have been provided with information about the Employee Wellness Program, understand the nature and purpose of the activities included, and have had the opportunity to ask questions.

I understand that my participation in the Wellness Program is voluntary and I may withdraw at any time without penalty.

I understand that all personal health information collected in connection with the program will be kept confidential in accordance with applicable laws and company policy.

By signing below, I consent to my participation in the Employee Wellness Program.

Employee Name Signature Date