Welcome to the TriHealth Healthy Directions Wellness Program - centralstate 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out the Wellness Program Registration Form. Clearly print your last name, first name, date of birth, and select your gender.
  3. Provide your home address, daytime phone number, city, state, zip code, and email address in the designated fields.
  4. Read and understand the consent section regarding your participation in the program. Sign and date where indicated.
  5. Complete the Tobacco Affidavit by certifying your tobacco use status. Ensure you sign and date this form as well.
  6. If applicable, fill out the Biometric Measures & Physical Confirmation section with your healthcare provider during your annual physical.
  7. Once all forms are completed, submit them via scan and email, secure fax, or mail as instructed.

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