Are you looking for a new and exciting way to workout? Check out Tufts Navigator Fitness Form! Our online fitness program offers a variety of exercises that are fun and easy to follow. Plus, our program is tailored to your individual fitness level. So whether you're just starting out or you're a seasoned athlete, Tufts Navigator Fitness Form has something for you! To get started, simply create an account and choose the exercise routine that's right for you.
This information will allow you to grasp better the details of the tufts navigator fitness before you begin filling it out.
|Form Name||Tufts Navigator Fitness|
|Form Length||1 pages|
|Avg. time to fill out||15 sec|
|Other names||capitals, MEMBERFITNESS, incurred, itemized|
GIC MEMBER FITNESS REBATE FORM
You must complete all ﬁelds. Please print clearly. Retain a copy of all receipts and documents for your records. Please be sure to sign the form.
To qualify for the ﬁtness club rebate, you must complete four consecutive months of membership in Tufts Health Plan and at a qualiﬁed ﬁtness center each year you apply.
You will have 24 months from the date you incurred your ﬁtness club fees to submit your request for the ﬁtness rebate of up to $150. The rebate applies one time per family , one time per year. The rebate is paid to the Tufts Health Plan subscriber after ﬁtness center fees are paid.
1. Member’s Name (Please print in capitals)
2.Member’s Tufts Health Plan ID #
3.Proof of payment through one of the following:
Please indicate which one of the following forms of proof of payment you are including with this form:
qAn itemized receipt from the ﬁtness club, showing the dates of membership and dollar amounts paid
qCopies of receipts for ﬁtness club membership dues
qA credit card statement or receipt
qA statement from the ﬁtness club on the ﬁtness club’s letterhead, with an authorized signature, indicating payment was made
In addition, you must include a statement from your ﬁtness club conﬁrming your membership for four consecutive months.
4. Member signature is required
I attest that the above information and enclosed proof of payment are accurate and complete.
(GIC Member Signature)
5. Please submit this form and all documentation to:
Tufts Health Plan
GIC Fitness Claims
705 Mt. Auburn Street
Please do not staple any materials to this form.