Workplace Wellness Program Enrollment

Workplace Wellness Program Enrollment — Form Fields

This business template includes 9 fields. Enroll in company-sponsored wellness programs such as fitness reimbursement, meditation, or coaching. Free to customize and use on ZenBuild.

• Employee Name (text, required)
• Employee Email (email, required)
• Department (text, required)
• Manager Name (text, required)
• Programs Interested In (checkboxes, required) — options: Gym membership reimbursement, Meditation/mindfulness app, Nutrition coaching, Mental health sessions, Step challenge, Financial wellness workshops, Yoga/fitness classes
• Employment Type (dropdown selection, required) — options: Full-time, Part-time, Contract
• Have you participated in wellness programs before? (multiple choice, optional) — options: Yes, No
• Health or Wellness Goals (long text, optional)
• Do you consent to anonymous aggregate wellness data being used for program improvement? (multiple choice, required) — options: Yes, No