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NICOTINE (COTININE) TEST Do you want to prove that you are tobacco free? You may do so by completing a nicotine test and submitting proof of your results. You will receive 400 points for completing the nicotine test, and an additional 400 points if your test results prove you are tobacco free! There two parts to earning all 800 points for the nicotine test. First, you must print off the necessary form and have it filled out by a doctor, clinic, or other health facility of your choice. Then, you must submit the completed form via the Go365 website. Instructions for both steps can be found below.

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PRINTING THE NECESSARY FORM 1. Log in to your Go365 account (go365.com)

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2. Click on “Activities” on the top of the screen

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3. Click on the “Healthy Living” button in the right/center of your screen to access Healthy Living activities

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4. Scroll down to see your Healthy Living activities. Click on “View details” to learn how to complete the activity

and how many points the activity is worth.

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5. Click on “cotinine test PDF” to download the necessary form for the nicotine (cotinine) test. A physician,

clinic or health facility will need to fill out the form.

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6. Within 90 days of completing the test, you must submit your documentation to the Go365 website.

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SUBMITTING DOCUMENTATION 1. Scroll to the top of the page, and click on the mail symbol

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2. Click on “Compose message” on the right side of the page to send a message to the Go365 team

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3. Choose “Go365” in the Category dropdown, and “Forms/Activity Submission” in the Subject dropdown. Click

“Add Attachment” to add your completed nicotine form, then scroll to the bottom of the page and click

submit.