Catapult Medical Exemption Form


  This form is completed by the physician. If you did not qualify for the wellness incentive or are unable to participate in the onsite preventive checkups because you were pregnant at the time of the checkups, as an alternative you may work with your physician to develop a plan to maintain or improve your health.

Catapult Primary Care Provider Form

  If you were not able to receive a Catapult Health Preventive Checkup this year, you may have your Primary Care Provider report lab and biometric values to receive credit toward the Office of Group Benefits wellness incentive being offered.