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Get and Sign Staples Wellness Claim Form

Get and Sign Staples Wellness Claim Form

Use a Staples Wellness Claim Form 0 template to make your document workflow more streamlined.

Purchase. This benefit allows a reimbursement based on the plan year (July-June). Please note, the benefit maximum is a dollar reimbursement per family per plan year. INFORMATION REQUIRED (Attach itemized 8.5 x 11 photocopies of paid receipts and a copy of your health club contract, weight loss program contract and/or fitness equipment detail obtained with purchase) Please identify the name of the Health Club, Weight Loss Program or name of Fitness Equipment (treadmill, elliptical, etc) being...
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