Virtual Education Sessions Form ENG

Value Added Service | Virtual Education Sessions

*Valid September 1, 2026 to August 31, 2027
Dear Cook Children’s Health Plan Member,

We would like to send you a one-time $25 reward for attending three Cook Children’s Health Plan Virtual Education Sessions. You may qualify for this gift card up to two times a year per household.

*Date of service must be within the current fiscal year (September 1, 2026 - August 31, 2027)
Member name:
(first and last name)
Member ID number:
Member DOB:

MonthDayYear
2 digit month, 2 digit day, 4 digit year
First Virtual Education Session Name of session Date of session
Second Virtual Education Session Name of session Date of session
Third Virtual Education Session Name of session Date of session
Please remember to register or log in to Healthmine to access your digital gift card and rewards.

Some limitations and restrictions may apply. Member must be active both on the date of service and on the date of request. If you have any questions please visit our website www.cookchp.org, contact us through the MyCookChildren’s Member Portal or call Member Services at 1-800-964-2247.
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