In completing the above information, I would like my company to utilize HealthWorks as one of our occupational health care options. By signing, I am aware of the products, services and cost effectiveness of this program. I am aware there is no cost involved to enroll in this program.
This form is not a legal document and is non-binding. I understand that I am not obligated in any way to use these services, but intend to provide HealthWorks as a choice to my employees.
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