Edit, Download, and Sign the Weight Watchers Proof of Participation Form
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How do I fill this out?
To fill out the Weight Watchers Proof of Participation form, start by selecting the Weight Watchers service you have completed and indicating your participation dates. Then, provide proof of participation by getting a signature from your leader or attaching an online subscription summary. Finally, fill out your personal information, choose your preferred communication method, and sign the form.
How to fill out the Weight Watchers Proof of Participation Form?
1
Select the Weight Watchers service you have completed.
2
Indicate your participation dates.
3
Provide proof of participation, either by signature or online subscription summary.
4
Fill out your personal details.
5
Choose your preferred communication method and sign the form.
Who needs the Weight Watchers Proof of Participation Form?
1
Active PEBB employees who want to rejoin Weight Watchers.
2
PEBB employees who have completed at least 10 weeks of their previous Weight Watchers series.
3
Employees who need to show proof of participation for Weight Watchers.
4
Individuals looking to renew their Weight Watchers membership.
5
Employees seeking a new Weight Watchers Access Code.
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1
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2
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5
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What are the instructions for submitting this form?
To submit this form, fax it to 1-888-598-7704, ensuring all sections are completed. Alternatively, you can mail the form to the address provided by your Weight Watchers representative or submit it through the designated online submission portal. Keep copies of all submitted materials for your records. It is advisable to confirm receipt of your form by contacting Weight Watchers directly.
What are the important dates for this form in 2024 and 2025?
The important dates for this form are January 1, 2024, to December 31, 2024, and January 1, 2025, to December 31, 2025. Please ensure all submissions fall within these date ranges.
What is the purpose of this form?
The Weight Watchers Proof of Participation form serves as a means for PEBB employees to rejoin the Weight Watchers program after completing at least 10 weeks of their previous series. By submitting this form with the required proof of participation, employees can qualify for another series and receive a new Weight Watchers Access Code. This form ensures that employees are actively participating in the program and helps facilitate their continued journey towards healthier living.
Tell me about this form and its components and fields line-by-line.
- 1. Weight Watchers Service: Check the applicable Weight Watchers service that you've just completed.
- 2. Participation Dates: Provide the start and end dates of your participation in the selected plan.
- 3. Proof of Participation: For At Work or Community Meetings, obtain a signature from your Weight Watchers leader or receptionist. For Online Subscriptions, attach a copy of your Weight Tracker summary.
- 4. Personal Information: Enter your last name, first name, middle initial, health plan ID number, address, city, state, zip, email address, phone number, and date.
- 5. Preferred Method of Return Communication: Indicate whether you prefer to be contacted by phone or email to receive your new renewal access code.
What happens if I fail to submit this form?
If you fail to submit this form, you will not be able to rejoin the Weight Watchers program.
- Ineligibility for New Series: You will not qualify for another Weight Watchers series without submitting proof of participation.
- No Access Code: You will not receive a new Weight Watchers Access Code needed to rejoin the program.
How do I know when to use this form?
- 1. Rejoining Weight Watchers: Use this form to qualify for another Weight Watchers series after completing 10 weeks of the previous one.
- 2. Proof of Participation: Submit this form to provide proof of participation in your previous Weight Watchers series.
Frequently Asked Question
How can I fill out the Weight Watchers Participation form on PrintFriendly?
Use our PDF editor to enter all the required information and make necessary selections. Save and download the completed form.
Can I provide proof of participation through an online subscription summary?
Yes, you can attach a copy of your Weight Tracker summary showing a minimum of 10 weeks participation in your 3-month subscription.
How can I sign the Weight Watchers Participation form on PrintFriendly?
Add your electronic signature directly to the form using our PDF editor, then save and download the signed document.
What should I do if I have questions about my health plan?
Contact your health plan provider directly using the number listed on your insurance card.
What is the preferred method of return communication for receiving the new renewal access code?
You can choose to receive the renewal access code either by a phone call or an email. Provide your preferred contact information on the form.
Are there any terms and conditions I need to agree to?
Yes, by submitting the form, you acknowledge and agree to the terms and conditions stated on the form, including eligibility and submission requirements.
Can I use PrintFriendly to edit the PDF and then share it with others?
Absolutely! After editing your PDF, you can share it via email or generate a shareable link using PrintFriendly's sharing features.
How can I track my Weight Watchers participation?
For online subscriptions, attach a copy of your Weight Tracker summary showing a minimum of 10 weeks participation.
Is it necessary to keep copies of the submitted form?
Yes, it is recommended to keep copies of all submitted materials as Weight Watchers and PEBB are not responsible for lost, late, or misdirected forms.
Who can use this form?
This form is available for active PEBB employees who wish to continue their Weight Watchers program after participating in at least 10 weeks of a prior series.
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