Wellness on the Go

Healthy Columbus comes to YOU (in-person or virtually)

Please complete this form in its entirety. Please submit requests a minimum of 2 weeks prior to the event. All services are subject to the approval by the Healthy Columbus staff.

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* 1. What services are you requesting? Check all that apply.

Stretching/Physical Activity Demos

Lunch & Learn with a Registered Dietitian

Information on Gym, Studio, and Race Discounts

Meditation/Breathing/Stress Management

Real Appeal Weight Loss Program

Tobacco Cessation

Healthy Columbus Program Overview Presentation

What's New with Healthy Columbus?

Specialty Group Fitness Class (limited one per quarter per location)

Other (please specify)

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* 2. If applicable, please provide further detail about the option/s you selected above.

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* 3. What is the preferred first choice date and time of the event?

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* 4. What is the second choice date/time of the event?

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* 5. How many people do you expect in attendance?

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* 6. What is the expected duration of the activity you're asking for?

15 minutes or less

15-30 minutes

30-45 minutes

45-60 minutes

60 minutes or longer

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* 7. What is your contact information?

First Name

Last Name

Phone Number

Department

Location Address