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Stanford Health Care
Stanford Children's Health
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Counseling (Help Center)
Weight Management (Omada)
Weight Management For Kids (Kurbo)
Quit Smoking (Kick it!)
For Your Team
1. What is your department name and location?
2. What is your name and title?
3. What is your work e-mail address?
Your work e-mail
Confirm work e-mail
4. How many employees are in your department?
5. Do you have at least one Wellness Champion on your team? (Yes or No)
6. Write a 2-4 sentence goal describing your commitment to promoting wellness habits through realistic, achievable changes.
7. Write 1 to 4 paragraphs describing how your team will accomplish this goal with grant funds.
8. Propose a budget between $200 and $1000. (Goals and activities must align with funds request.)
9. Select your team’s level of wellness practice and knowledge:
Wellness Pioneers (beginners)
Wellness Experts (intermediate)
Wellness Visionaries (advanced)
10. Which wellness practices does your department already have implemented: (Check all that apply)
Access to healthy food
Remove candies and sweets from work space
Designated area to share food
Food provided by department offers healthy options
Number of staff currently trained in nutrition standards
Opportunity for physical activity
Sponsored 1+ wellness activity (must be physical fitness)
Stretch breaks at meetings
Work break information or education posted
Smoke-free lifestyle signs posted
Employee engagement Managers encourage employee participation in HealthySteps
Managers encourage employee participation in other hospital-sponsored wellness activities