Free form template · Word

Wellness Program Registration

A wellness program registration form is the sign-up sheet for a specific wellness activity, such as a yoga batch, step challenge or fitness camp. It confirms the batch, checks basic fitness readiness and records the participant's voluntary participation and consents.

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[Company Logo][Company Name]

WELLNESS PROGRAMME REGISTRATION FORM

Programme:: [Programme Name]
Organised by:: [Company Name], HR
Dates:: [DD/MM/YYYY] to [DD/MM/YYYY]
Venue / Link:: [Venue]
Registration Closes:: [DD/MM/YYYY]

Participant Details

Employee Name
Employee ID
Department
Work Location
Mobile Number
Team Name (for challenges)

Batch Selection

Batch	Days	Time	Seats	Select
Morning	[Mon, Wed, Fri]	[7:00-7:45 am]	[Number]	[ ]
Lunch	[Tue, Thu]	[1:15-1:45 pm]	[Number]	[ ]
Evening / Online	[Mon-Fri]	[6:30-7:15 pm]	[Number]	[ ]

Fitness Readiness

Has a doctor advised you to avoid physical activity? Yes / No
Do you have any injury or condition the trainer should know about? Yes / No (details optional)
If Yes to either, I have consulted / will consult a doctor before participating

Emergency Contact

Name
Relationship
Mobile Number

Consent

I am joining this programme voluntarily. I will follow the trainer's instructions, stop if I feel unwell, and participate within my own limits. I consent / do not consent to my photographs and challenge results being shared on internal channels.

Participant
[Employee Name]
Date: [Date]

Registered by
[HR Name]
Batch Confirmed: [Batch]

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What this template includes

Programme name, dates and batch timings
Team name for challenges
Fitness readiness questions with doctor-consultation advice
Voluntary participation and assumption of risk statement
Photo and leaderboard consent
Emergency contact

When to use it

To register employees for a fixed-batch yoga or Zumba programme
For a company-wide step or cycling challenge with teams
Before a physically demanding event such as a corporate run
To manage limited seats for a nutrition or mindfulness course

How to customise this template

1Enter the specific programme, venue and trainer
2Edit the batch table to match your schedule
3Drop the team section for individual programmes
4Add T-shirt size if you give event kits

HR tips

Do not ask for detailed medical history; a readiness check is enough
Waitlist rather than overbook limited batches
Make photo consent separate and optional
Share a reminder and venue details a day before

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Frequently asked questions

Why do wellness events need a readiness check?+

It prompts participants with heart, joint or other conditions to consult a doctor before strenuous activity, which supports safety.

Can employees join wellness programmes during work hours?+

That depends on company policy and manager approval. Many firms schedule sessions before shift, at lunch or after hours.

Is participation in wellness programmes mandatory?+

Wellness programmes are normally voluntary. Registration forms should say so clearly.

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[Company Logo][Company Name]

EMPLOYEE WELLNESS PROGRAM: NEEDS AND INTEREST FORM

Company:: [Company Name]
Survey Period:: [DD/MM/YYYY] to [DD/MM/YYYY]
Coordinator:: [HR Name]

We are planning our wellness calendar for [Year]. Your answers will help us choose activities that suit you. Questions about health are optional and responses will be reported only in aggregate.

About You (optional)

Name (optional)
Department
Work Location
Work Pattern: General Shift / Rotational Shift / Remote / Hybrid
Age Group: Under 25 / 25-34 / 35-44 / 45-54 / 55+

Rate Your Interest (1 = low, 5 = high)

Programme	Interest (1-5)	Preferred Format
Yoga and stretching	[1-5]	[On-site / Online]
Gym or fitness challenge	[1-5]	[On-site / App]
Nutrition and diet talks	[1-5]	[On-site / Online]
Stress management and mental health	[1-5]	[On-site / Online]
Sleep and lifestyle workshops	[1-5]	[Online]
Financial wellness (tax, savings)	[1-5]	[Online]
Preventive health check-up	[1-5]	[On-site / Lab]

Form · Word

Employee Wellness Program Form

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[Company Logo][Company Name]

ANNUAL HEALTH CHECKUP REGISTRATION

Company:: [Company Name]
Diagnostic Partner:: [Partner Name]
Checkup Window:: [DD/MM/YYYY] to [DD/MM/YYYY]
Coordinator:: [HR Name]

Employee Details

Employee Name
Employee ID
Department
Work Location
Date of Birth
Gender
Mobile Number
Email ID

Package Selection

Package	Eligible Age Group	Key Tests	Cost to Employee (₹)	Select
Basic	Below 35	[CBC, blood sugar, lipid profile, urine]	Nil	[ ]
Comprehensive	35 and above	[Basic + thyroid, liver, kidney, ECG]	Nil	[ ]
Women's Health Add-on	All	[Tests as per partner]	[Amount]	[ ]
Spouse / Parent Package	All	[As per package]	[Amount]	[ ]

Appointment Preference

Form · Word

Health Checkup Registration

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[Company Logo][Company Name]
EMPLOYEE ASSISTANCE PROGRAMME (EAP) REQUEST FORM
Company:
[Company Name]
EAP Provider:
[Provider Name]
24x7 Helpline:
[Phone Number]
Date:
[Date]
Confidentiality: Your request goes to [Provider Name]. The company receives only anonymous, aggregated usage data. Information is shared only with your consent or where there is a serious risk to safety. If you are in immediate danger, call [Emergency Number] or go to the nearest hospital.
Who Needs Support
Name of Person Seeking Support
Relationship to Employee: Self / Spouse / Child / Parent
Employee ID (for eligibility check only)
City
Type of Support
- Emotional wellbeing and counselling
- Work stress or relationship at work
- Family or relationship concerns
- Legal information and guidance
- Financial and debt guidance
- Childcare or eldercare information
- Grief or critical incident support
Form · Word
Employee Assistance Program Form
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[Company Logo][Company Name]
CANTEEN REGISTRATION FORM
Company / Unit:
[Company Name], [Work Location]
Canteen Contractor:
[Contractor Name]
Effective From:
[DD/MM/YYYY]
Date:
[Date]
Employee Details
Employee Name
Employee ID / Token No.
Department
Shift: General / A / B / C
Mobile Number
Meal Plan
Meal Timing Subsidised Rate (₹) Opt (Y/N)
Breakfast [HH:MM-HH:MM] [Amount] [Y/N]
Lunch [HH:MM-HH:MM] [Amount] [Y/N]
Evening Tea and Snacks [HH:MM-HH:MM] [Amount] [Y/N]
Dinner (night shift) [HH:MM-HH:MM] [Amount] [Y/N]
Food Preference
Form · Word
Canteen Registration Form
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[Company Logo][Company Name]
EMPLOYEE BENEFITS ENROLLMENT FORM
Company:
[Company Name]
Form No.:
[Reference Number]
Date of Submission:
[Date]
Enrollment Deadline:
[DD/MM/YYYY]
Please complete all sections within the enrollment window and return this form to [HR Name], Human Resources. Benefits will be activated only after HR verification.
Section A: Employee Details
Employee Name (as per PAN)
Employee ID
Designation
Department
Date of Joining
Work Location
Date of Birth
Gender
Mobile Number
Personal Email
PAN
Aadhaar (last 4 digits only)
Section B: Statutory Benefits
UAN (if already allotted)
Previous PF Account / Member ID
ESI IP Number (if applicable, for gross wages up to ₹21,000/month)
Opting for higher PF contribution: Yes / No
Form · Word
Employee Benefits Enrollment Form
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Name of Person Seeking Support
Relationship to Employee: Self / Spouse / Child / Parent
Employee ID (for eligibility check only)
City

Meal	Timing	Subsidised Rate (₹)	Opt (Y/N)
Breakfast	[HH:MM-HH:MM]	[Amount]	[Y/N]
Lunch	[HH:MM-HH:MM]	[Amount]	[Y/N]
Evening Tea and Snacks	[HH:MM-HH:MM]	[Amount]	[Y/N]
Dinner (night shift)	[HH:MM-HH:MM]	[Amount]	[Y/N]

Employee Name (as per PAN)
Employee ID
Designation
Department
Date of Joining
Work Location
Date of Birth
Gender
Mobile Number
Personal Email
PAN
Aadhaar (last 4 digits only)

UAN (if already allotted)
Previous PF Account / Member ID
ESI IP Number (if applicable, for gross wages up to ₹21,000/month)
Opting for higher PF contribution: Yes / No

[Company Logo][Company Name]

FLEXIBLE BENEFITS SELECTION FORM

Company:: [Company Name]
Financial Year:: [FY 20XX-XX]
Submission Date:: [Date]
Payroll Cut-off:: [DD/MM/YYYY]

Part 1: Employee Information

Employee Name
Employee ID
Designation
Department
Annual CTC: ₹[CTC]
Annual Flexi Basket: ₹[Amount]
Tax Regime Opted: Old / New

Part 2: Allocation of Flexi Basket

Component	Company Limit per Month (₹)	My Monthly Allocation (₹)	Annual Allocation (₹)	Bills Required
Meal Card / Food Coupons	[Amount]	[Amount]	[Amount]	No (card based)
Fuel and Vehicle Maintenance	[Amount]	[Amount]	[Amount]	Yes
Telephone and Internet	[Amount]	[Amount]	[Amount]	Yes
Leave Travel Allowance	[Amount]	[Amount]	[Amount]	Yes, travel proof
Books and Periodicals	[Amount]	[Amount]	[Amount]	Yes
Employer NPS Contribution	[Amount]	[Amount]	[Amount]	No
Total (must equal flexi basket)	-	[Amount]	[Amount]	-

Part 3: Terms

Form · Word

Benefits Selection Form

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[Company Logo][Company Name]
GROUP MEDICAL INSURANCE (GMC) ENROLLMENT FORM
Policyholder:
[Company Name]
Insurer:
[Insurer Name]
TPA:
[TPA Name]
Policy No.:
[Policy Number]
Policy Period:
[DD/MM/YYYY] to [DD/MM/YYYY]
1. Primary Member (Employee)
Employee Name (as per ID proof)
Employee ID
Date of Birth
Gender
Date of Joining
Work Location
Mobile Number
Email ID
2. Coverage Selection
Sum Insured Tier: ₹[Amount] / ₹[Amount] / ₹[Amount]
Basis: Family Floater / Individual
Voluntary Top-up: Yes / No, Sum Insured ₹[Amount]
Parental Cover: Parents / Parents-in-law / None
3. Family Members to be Covered
Form · Word
Group Medical Insurance Enrollment
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Employee Name (as per ID proof)
Employee ID
Date of Birth
Gender
Date of Joining
Work Location
Mobile Number
Email ID

Sum Insured Tier: ₹[Amount] / ₹[Amount] / ₹[Amount]
Basis: Family Floater / Individual
Voluntary Top-up: Yes / No, Sum Insured ₹[Amount]
Parental Cover: Parents / Parents-in-law / None

[Company Logo][Company Name]

GROUP INSURANCE NOMINATION FORM

Company:: [Company Name]
Policy:: Group Term Life / Group Personal Accident
Insurer:: [Insurer Name]
Policy No.:: [Policy Number]
Date:: [Date]

Employee Details

Employee Name
Employee ID
Designation
Department
Date of Birth
Date of Joining
Marital Status

Nominee Details

Nominee Name	Relationship	Date of Birth	Address and Mobile	Share (%)
[Nominee Name]	[Relationship]	[DD/MM/YYYY]	[Address, Mobile]	[%]
[Nominee Name]	[Relationship]	[DD/MM/YYYY]	[Address, Mobile]	[%]
[Nominee Name]	[Relationship]	[DD/MM/YYYY]	[Address, Mobile]	[%]
Total				100%

Appointee (only if a nominee is a minor)

Form · Word

Group Insurance Nomination Form

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Employee Name
Employee ID / Token No.
Department
Shift: General / A / B / C
Mobile Number

Wellness Program Registration

Preview of the form

Participant Details

Batch Selection

Fitness Readiness

Emergency Contact

Consent

What this template includes

When to use it

How to customise this template

HR tips

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Frequently asked questions

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