Healthy Streets: Adopt a Planter

Thank you for reaching out to Healthy Streets! Please fill out this form if you are interested in taking care of a planter box at a permanent Healthy Street location! You will need to complete this form and submit a Landscape Maintenance Agreement.

If you have any questions, please email us at HealthyStreets@seattle.gov

Privacy Notice:
Information provided in this survey is considered a public record and may be subject to public disclosure. For more information, see the Public Records Act, RCW Chapter 42.56. To learn more about how we manage your information, see our Privacy Statement.

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* 1. What is your Healthy Street Location?

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* 2. Tell us about you!

Name *

Street Address

ZIP/Postal Code *

Email Address *

Phone Number

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* 3. Do you live at the intersection where you want to adopt a planter box? See example diagram of a Healthy Streets intersection below.

Yes

I'm not sure