Healthy Community Alliance Partner Registration

The mission of the Healthy Community Alliance of East Central Indiana (HCA) is to “improve the health and well-being of the communities we serve.” As we work together to align stakeholders’ individual strengths into a collective effort for improved community health, it is imperative that we have support and input from a variety of diverse partners committed to working together in multiple areas.
HCA Partners may include organizations, businesses, or individuals that agree to participate in the activities of the Healthy Community Alliance of East Central Indiana with the goal of influencing audiences such employees, clients, students, parishioners, and/or neighborhood residents to make healthy lifestyle choices.

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* 1. HCA Partner Commitment:
As a Partner, I/we will promote the HCA’s mission to improve the health and well-being of the communities we serve; and share information, education, best practices and community-based wellness opportunities within my organization and to other community audiences when possible.

Yes, please sign me up to represent the organization listed below as part of the Healthy Community Alliance Partner network!

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* 2. Please provide your contact information

Organization

Your Name

Your Title/Role

Email address

Phone number

Physical address

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* 3. I/we have a particular interest in helping my/our audiences promote healthy lifestyles in one or more of these HCA Workgroup areas: (please select at least one)

Moving More/Increasing Physical Activity

Eating Better/Improved Nutrition/Food Access

Tobacco/Vaping Prevention and Cessation

Thank you for joining the Healthy Community Alliance! You will receive an email verification and welcome information shortly! -John Disher, Facilitator, Healthy Community Alliance of East Central Indiana. jdisher1@iuhealth.org