HRA Form

Health Survey

Please fill out this health survey to get started in DHF.

What it is?: When you complete your health assessment, you'll open the door to additional tools that will help you with your custom health goals. You'll be asked questions about your overall health, medical history, and things like diet and exercise to get a complete picture of your overall health and wellbeing.

Benefit to you?: Each question will help create an overall view of where your health is today so you can take the next step forward in improving your health- whether you're looking to eat healthier, reduce stress, lose weight, quit smoking, or even sleep better.

Is it safe and confidential?: All of your answers are completely confidential and in no way will be shared with anyone at Prime Inc. In no way will your employment status be affected by any answers you use. It is HIPAA secured and completely CONFIDENTIAL!

Cost?: Free for Prime drivers.

Getting Started: Take the assessment whenever you're ready to get started in DHF. It will take about 15 minutes to complete.

  • Prime Inc. sponsors one or more voluntary wellness programs designed to promote health or prevent disease. If you choose to participate in DHF, you may provide health information by answering questions or having screenings. The kind of health information will vary depending on the program. It may include such things as your blood pressure and glucose levels. This Notice is about how we will use and protect the information.
  • You may also provide genetic information in the form of information about your past or present medical conditions. We must have your voluntary and knowing authorization below to collect this.
  • The health and genetic information will be used by us for purposes of the wellness program. It will only be shared with:
    • You, so you can understand your health risks;
    • Those running the wellness programs (AKA the DHF Wellness Team);
    • Your Prime Wellness team, in aggregate form that does not identify anyone, to design programs to address health risks that will better help our drivers.
  • No one else will see the information. We will follow stringent privacy and security procedures to prevent it from being improperly disclosed. Our methods will comply with all applicable privacy laws. For example, the information will be stored and encrypted, and precautions will be taken to avoid data breaches as these laws require.

By selecting “I Accept” you are authorizing us to collect the genetic information described above. If you do not authorize, select “I decline.” If you select “I decline” you will not be allowed to proceed and will return to the previous page.