Get Pehp Waist Aweigh

This guide provides a detailed walkthrough for completing the PEHP WAIST AWEIGH online weight verification form. Following these steps will help ensure a smooth process for submitting your information and receiving potential rebates for participation in the program.

Follow the steps to complete the PEHP WAIST AWEIGH form online.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. In the first section, provide your participant name, including your first name, middle initial, and last name. Double-check for accuracy before proceeding.
3. Enter your PEHP Member ID by locating the last six digits on your PEHP ID card and inputting them into the designated field.
4. Sign the participant signature field to confirm the accuracy of the information provided. This step is essential for compliance.
5. Fill in your phone number in the participant phone section to allow PEHP to contact you if necessary.
6. The following fields are to be filled out by a health, fitness, or medical professional. Ensure they input the date, your current weight, and the name of the facility where your weight is verified.
7. Provide the phone number, address, city, state, and zip code of the facility verifying your weight. Make sure all information is complete.
8. The professional must fill in their name, title, and provide their signature in the designated fields, confirming the verification is accurate.
9. Once all sections are completed, check for any missing information or errors. It is crucial since no rebate will be processed if the form is not signed.
10. After verifying all information is accurate, you can save the changes, download the document, print it, or choose to share it as needed.

Begin filling out your document online to ensure timely submission and eligibility for rebates.