Results for Downloads

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Download the 2018 Take Action mailer for information about the different options for completing your Take Action activities.

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To verify proof of health care coverage for you or your dependents, follow the process through EmployeeConnect. Download the instructions here.

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If you do not meet one or more of the healthy targets, your health care provider can complete and sign this form for an appeal. Download the form here.

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Download the 2018 Health Care Provider Form and take it to your doctor for four of your health screening measures today! And download the Self-Administered Cardiorespiratory Test Submission Form, which includes instructions on how to complete this part of your 2018 screening yourself. You must fill out both forms to complete your health screening.

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Download the 2018 health screening mailer to remind yourself how the screening worked last year based on your work location.

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Looking for downloads from last year? Visit the Health Management Program download archive.

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EmployeeConnect is your online source for enrolling in your benefits, learning more about opportunities at Rockwell Automation and viewing your personal benefits information.

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Request Proof of Health Care Coverage

To verify proof of health care coverage for you or your dependents, follow the process through EmployeeConnect. Download the instructions here.

2018-2019 StayWell Health Care Provider Forms

Download the 2018 Health Care Provider Form and take it to your doctor for four of your health screening measures today! And download the Self-Administered Cardiorespiratory Test Submission Form, which includes instructions on how to complete this part of your 2018 screening yourself. You must fill out both forms to complete your health screening.

2018 Health Screening Appeal Form

If you do not meet one or more of the healthy targets, your health care provider can complete and sign this form for an appeal. Download the form here.

2018 Take Action Mailer

Download the 2018 Take Action mailer for information about the different options for completing your Take Action activities.

2018 Health Screening Mailer

Download the 2018 health screening mailer to remind yourself how the screening worked last year based on your work location.

Health Management Archive

Looking for downloads from last year? Visit the Health Management Program download archive.