Request Vitality GO membership

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Request Vitality GO membership

Policy owner information

Policy number

Owner first name

Owner last name

Owner email address

Insured information (if different than policy owner)

Insured first name (optional)

Insured last name (optional)

Insured email address (optional)

I authorize John Hancock to add the Healthy Engagement Core Rider (Vitality GO) to the life insurance policy listed above and have read, understand and agree to the terms and conditions in the Authorization to Share Information and Consent to Electronic Records Delivery and Communications.

Policy number can be found on your policy documentation.

John Hancock Vitality GO is not available for policies issued in New York, or Puerto Rico.

John Hancock Vitality Program rewards and discounts are only available to the person insured under the eligible life insurance policy. Premium savings are not available with the John Hancock Vitality GO Program.

Thank you for submitting your Vitality GO request.

We'll be in touch shortly to confirm that Vitality GO has been added to your policy and provide information on how to get started with your Vitality Health Review.

In the meantime, if you have any questions about the Vitality GO program, give us a call at 888-333-2659. We’re here to help.