Application Directions

Healthy Gallatin and the Gallatin Breastfeeding Coalition would like to recognize employers in Gallatin County that provide worksite breastfeeding support for employees with the “Healthy Gallatin Breastfeeding Friendly Worksite Award.”  In accordance with Section 7 of the Fair Labor Standards Act of 1938 (29 U.S.C. 207) and the 2010 amendment, employers are evaluated based on criteria for three levels of support: Gold, Silver, and Bronze.  Following a site visit, employers meeting one of these levels will be recognized with a framed certificate, window cling, recognition on the Healthy Gallatin (www.healthygallatin.org) and Gallatin Breastfeeding Coalition (www.gallatinbreastfeedingcoalition.org) websites and Facebook pages, annually at our Big Latch On event, and in a quarterly press release to the media (if so desired).

Using this form, please provide the required information about your worksite and indicate the level of accommodation your worksite currently has for breastfeeding employees.  Criteria are listed by certification level in the checklist provided. 

After you submit your application, a technical advisor will contact you to  discuss the certification level of your organization and discuss any questions you might have.

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1. Please enter your worksite information:

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2. Using the checklist provided below, please indicate your organization's level for each criteria:

  Bronze Silver Gold
Policy and Education
Facilities
Scheduling
Resources

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4. The Health Department is available to assist you in reaching your compliance goals.  Please tell us what we can do to help you reach your desired certification level.

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5. Please upload a copy of your breast feeding workplace policy.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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6. Please upload your organization's logo.

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7. Please upload a picture of your breast feeding space.

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8. Does the Gallatin City-County Health Department have your permission to post your successes on our Facebook page?

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