What is a wellness program participation consent?
Workplace wellness programs ask for something sensitive: health information. Employees are far more willing to join when they can see, in writing, that taking part is optional, that individual results stay with the provider, and that leaving costs them nothing beyond an unearned reward.
This consent names the program, the employer and any outside provider, the program period and its activities. It lists the health information collected, who sees individual results, that the employer gets only grouped figures, how long data is kept, and that it's never sold or used for advertising. It covers private follow-up on a worrying screening result, any incentive with a reasonable alternative and a note on tax, the right to skip any activity, and how to leave the program and ask for data to be deleted.
- Best for
- HR and benefits teams running voluntary wellbeing programs
- Signed by
- The employee and the employer
- Employer sees
- Grouped figures only, never individual results
- Length
- 2 pages
When to use a wellness program participation consent
- Annual biometric screening with a gift-card reward
- A company step or cycling challenge using a fitness app
- Health risk questionnaires run by an outside provider
- Lunchtime yoga, mindfulness or stop-smoking courses
- Flu-season wellbeing weeks with optional checks
What you fill in
12 blanks, then the name and email of each person who signs: employee, employer.
1 The program
- Employer*
- Program name*
- Outside wellness provider (optional)
- Program period*
- Activities*
2 The employee
- Employee's name*
3 Your information
- Health information collected*
- Who sees individual results*
- How long data is kept*
4 Incentive
- Incentive (optional)
- Alternative way to earn it*
5 Withdrawal
- Questions and withdrawal — contact*
6 Who signs
- Employee signature and date
- Employer signature and date, job title
What the wellness program participation consent covers
- Taking part is my choice
- Activities
- My health information
- Incentives
- Leaving the Program
- Consent
Using the wellness program participation consent, step by step
1 The program
Your company name fills in from your account. Add the program name, the provider if you use one, the dates and the activities.
2 Health information
List what's collected, who sees individual results and how long it's kept. Be specific: this is the part employees read most carefully.
3 Incentives
Describe any reward and the alternative for people who can't take part for medical or other reasons, or leave it empty for none.
4 Send to staff
Send it to each employee who wants to join. They sign on any device, you countersign, and FileIt keeps every signed consent together.
Tips before you send it
- Keep incentives modest so taking part stays genuinely voluntary.
- Have an outside provider hold individual data wherever you can.
- Rules on wellness incentives and health data differ between places and health plans. Check yours.
- Repeat consent each program year, especially if the activities or data change.
Sign it online in minutes
- Fill in the blanks. Names, dates and amounts go straight into the agreement — the preview shows exactly where.
- Name who signs. Tick “This is me” for your own part. FileIt builds the PDF with every signature, date box on the right line, and you can check or move anything before sending.
- Send it. Each signer gets a secure link and signs from any device — no account needed. The signed PDF, with an audit trail and a Certificate of Completion, is filed in your vault and emailed to everyone.
Wellness program participation consent: frequently asked questions
Will the employer see my results?
Not individually. The form says the employer receives only grouped figures that don't identify anyone, and won't use your information in employment decisions.
What if I can't do an activity?
You may skip any activity or question. Where there's an incentive, the form says you can ask HR for a reasonable alternative.
Can I leave later?
Yes, at any time. You may also ask for your data to be deleted unless the law requires it to be kept. Leaving may mean missing an unearned reward, nothing more.
Is the wellness reward taxable?
It can be, depending on the reward and where you live. The form says the employer will tell you if it is.