Workplace Wellness Inquiry
When received, we will contact you with more information.
Street Address Line 2
State / Province
Postal / Zip Code
Point of Contact
Please enter a valid phone number.
Wellness Program Interest
Our company is interested in the following:
Flu Shot Clinic
COVID Vaccine Clinic
Health Screening (blood pressure, blood glucose, etc)
Weight Loss Program
If you checked the 'other' box, please share what ideas you have to improve your workplace wellness.
Location for wellness offering:
On-site at our company
At the pharmacy
Total number of employees:
Estimated number of participating employees:
Should be Empty: