Mental Health Awareness Month

Personal Story Submission Form

Thank you for sharing your story. Please take a minute to complete this short submission form.

Please complete and submit by May 31, 2022.

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* 1. Your Name:

First name:

Last name:

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* 2. Your e-mail address:

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* 3. Please indicate if you are:

Primary HealthFlex participant

Spouse covered by HealthFlex

Dependent covered by HealthFlex

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* 4. Conference or Employer Name:

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* 5. What HealthFlex program(s) have been helpful to you in supporting your emotional well-being?

Employee Assistance Program

Talkspace through the Employee Assistance Program

Virgin Pulse Health Coaching

MDLIVE Behavioral Health

Working with a provider through your behavioral health benefits

Other (please specify)

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* 6. Will you allow Wespath Benefits and Investments to share your story? It could be used in or posted on any medium, including but not limited to, the Virgin Pulse website, Wespath print publications, social media accounts and websites, for any purpose that Wespath and those acting pursuant to its authority deem appropriate, including promotional or advertising efforts. If you answer “Yes,” you may be asked to sign a release form in the future.

Yes

No