Musculoskeletal
Support Program
Enrollment

Type one or more of the following areas: head, neck, shoulder, arm, wrist, upper back, lower back, hip, leg, ankle, foot, other/unsure

Type one or more of the following symptoms: pain, weakness, injury, instability, pins and needles, numbness, stiffness, swelling, immobility, other/unsure

• I have read and understood the Privacy Notice and Legal Disclaimer provided by the Cigna Group.
• I voluntarily consent to participate in the Clinical Health Program, which is designed to support individuals through clinical assessments, health coaching, digital tools, and teleconsultations. I may choose not to enroll or may withdraw at any time without affecting my existing insurance coverage. To withdraw, I may contact my nurse case manager via email or call the customer service number provided on the back of my global ID card. I acknowledge that the program may include virtual care interactions, such as audio or video calls for assessments, consultations, and follow-ups.
• I authorize the Cigna Group and its affiliates (collectively, the “Cigna Group”) to collect, use, and disclose my personal data, including health information and medical records, for the purpose of delivering and improving the Clinical Health Program. This includes clinical evaluation, personalized care planning, progress monitoring, requesting feedback, quality assurance, and other purposes described in the Cigna Privacy Notice.
• I understand that my personal data will only be accessed and processed by authorized personnel of the Cigna Group and by trusted third-party partners strictly as necessary to deliver and improve the Clinical Health Program. All such processing will occur under robust confidentiality obligations and in full compliance with applicable data protection laws and contractual safeguards.
• I understand that my personal data may be transferred and securely stored in jurisdictions outside my country of residence (including in the United States and European Union) where Cigna operates. Such transfers will occur in accordance with applicable cross-border transfer laws, including the use of appropriate safeguards and contractual protections.
• I acknowledge that the Cigna Group shall be held harmless from any liability arising directly or indirectly out of the services provided by healthcare professionals in relation to the Clinical Health Program, and any breach of laws committed by the healthcare professionals.
• I confirm that I have read and understood the above terms and voluntarily consent to the collection and processing of my personal data, participation in the Clinical Health Program, and all related terms described above.