Wellness Agreement Sample Contracts

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Wellness Agreement 2014 - 15
Wellness Agreement • April 2nd, 2014

The residents of the Shea Hall Wellness floors have selected this form of housing in order to live with residents who have made a similar commitment to a lifestyle free from the influences of alcohol and all illegal or illicit drug use. As a resident of a wellness floor, I hereby agree to make a positive personal commitment to maintain this community expectation. Evidence of this commitment shall be through managing my own behavior and the behavior of my guests as it relates to substance abuse on and off campus.

Wellness Agreement
Wellness Agreement • February 5th, 2020

As a UCAN staff member, I am dedicated to supporting our program participants toward meeting their goals. Along with my colleagues, I am on the front line of service delivery. On a daily basis, many of us, as well as the people we serve, experience trauma such as family violence, gang violence, gun violence, and associated losses.

Wellness Agreement for a St. Andrew’s Youth Family
Wellness Agreement • August 11th, 2021

Description of event: Our youth offerings are for grades 6th – 12th and will be held September 2021 to September 2022. This form also includes serving as an Acolyting which you can begin participating in 5th grade. Offerings will meet on the grounds of St. Andrew’s Episcopal Church, 1004 Graydon Avenue, Norfolk, VA 23507 or other designated St. Andrew’s sponsored events within the state of Virginia. The instructors for this offering will include a St. Andrew’s Staff person along with St. Andrew’s Teen Parents and Parishioners. When on the church grounds, we will plan to meet either outside on the church front lawn or the White Hall patio or inside in White Hall, the Auditorium, Room 207, or the Church.

Isthmus Wellness Agreement
Wellness Agreement • January 23rd, 2019 • Wisconsin

Thank you for choosing Isthmus Wellness for your care. Rates are available on Isthmus Wellness’ price sheet, or on Isthmus Wellness’ website: http://isthmuswellness.com/services/rates-and-packages/. The following terms and conditions apply to all services received from Isthmus Wellness:

Wellness Agreement
Wellness Agreement • September 15th, 2020

To safeguard the health of all, youth and their parent(s) or guardian(s) must commit to following a set of expectations and norms to minimize the transmission of COVID-19. These standards are the recommendations of medical and public health professionals and meet or exceed federal and state guidelines. All youth who plan to participate in the event outlined in the description of event section must commit to the expectations below.

Wellness Agreement Between
Wellness Agreement • March 19th, 2020

If “yes,” you may have the flu or other communicable disease. Symptoms of flu include fever or chills and cough or sore throat. In addition, symptoms of flu can include runny nose, body aches, headache, tiredness, diarrhea, or vomiting.

UPG Live Well
Wellness Agreement • February 18th, 2016

This wellness agreement is between the USPM Health & Wellness Advisor and the UPG Employee and outlines the responsibilities and key commitments made by both parties. Any information shared within this relationship is confidential and the advisor representing U.S. Preventive Medicine respects the member’s right to privacy and will maintain records created, stored, accessed, transferred, and/or disposed of following National HIPAA Regulations.

Massage Envy Wellness Agreement
Wellness Agreement • August 6th, 2021

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Massage Envy Wellness Agreement
Wellness Agreement • May 25th, 2022

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RHNS WELLNESS AGREEMENT
Wellness Agreement • September 5th, 2020

All members of our school community must understand and agree to comply with our school policy regarding COVID-19 and other illnesses. This statement follows guidance from the State of Connecticut Office of Early Childhood (OEC) Licensing Division, incorporating guidance issued by the Department of Health (DOH) and Centers for Disease Control (CDC) for early childhood programs.

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