Healthy Community Coalition

The Healthy Community Coalition needs you! Whether you have a lot or a little time to volunteer, all input is valuable and every voice counts. Please fill in the information below and you will be contacted by the Coalition Coordinator.


	Name, type of comment, comments, and at least one type of contact information are required.

Your Name:
Type of Comment:	General Information about the Coalition Health Equity Action Team Environmental Health Team Reproductive Health Team Lifestyle and Behaviors Team Domestic Violence Team
Your Comments:
	Please give an email and/or a phone number.
Email:
Re-type Email:
Primary Phone:
Secondary Phone: