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CONGRATULATIONS! YOU'VE TAKEN A POSITIVE STEP TOWARDS
TAKING CONTROL OF YOUR HEALTH!

REGISTRATION FOR OUR WINTER WELLNESS CHALLENGE 360° OPENS DECEMBER 1ST

1 morning session, and 2 evening to fit your schedule

Tuesdays
January 15th—March 5th
10:00 am

Wellness Coach:
CASEY McGOWIN

Thursdays
January 17th—March 7th
6:00 pm

Wellness Coach:
CASEY McGOWIN

Tuesdays
January 29th—March 19th
6:00 pm

Wellness Coach:
PEGGY KRAUS

All classes held at Wellness Foundation, 34 Bay Street, Sag Harbor

ONCE YOU'VE REGISTERED AND SECURED YOUR SPOT,
FOLLOW THESE STEPS TO GET STARTED!

Circle1

Fill out the online forms one week prior to the first class:

Participant’s consent

Liability release

WC 360° Questionnaire

Circle2

Contact your doctor for*:

Signed physician’s consent

TWO prescriptions for blood work: lipid panel and A1C (one for the beginning lab work and one for the completion lab work)

(*Your doctor may require you to make an appointment before signing the physician’s consent form or providing blood work prescriptions.)

Please note that you may NOT attend the first class unless these forms are completed and signed and your labs have been submitted.

Circle3

Get your blood work done

Remember that fasting is required

Ask your doctor and lab to fax the blood work directly to us at 631-329-3714 or info@wfeh.org

Plan to follow up with your doctor and your lab to make sure they have faxed us your blood work as this is your responsibility, not your doctor’s or the lab’s. If you have a copy of your labs, please feel free to fax them to us yourself.

If your insurance company will not pay for the blood work, we have arranged a reduced rate of $30 per visit with Stony Brook Southampton Hospital (631-726-8250)

Circle4

Fill out final online questionnaire during week 6

Get final labs done directly following week 6 class

BEFORE YOU START WC360°:

Click here to fill out the

Pre-Wellness Challenge 360°

online Health Questionnaire

PRE-CHALLENGE HEALTH QUESTIONNAIRE

UPON COMPLETION OF WC360°:

Click here to fill out the

Post-Wellness Challenge 360°

online Health Questionnaire

POST-CHALLENGE HEALTH QUESTIONNAIRE