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    LINK TO TESTING FORM

    Live Well Community Interest Form

    This form is intended for municipalities in Allegheny County interested in joining the Live Well public health campaign. If you are interested, complete this form and a team member will be in touch!

    "*" indicates required fields

    Becoming a Live Well Community is easy! A Live Well Community agrees to work alongside Live Well Allegheny to promote the health and well-being of their residents.

    Once you declare interest via this form, a team member will be in touch to help get you on board. You must pass a resolution within your council aimed at addressing three action items to improve your resident’s health. Action items could include designated no smoking areas in public spaces, expanding biking trails and even sharing health information with your residents. The possibilities are endless, and our team is here to help you navigate this process.

    Use the space below to place any questions that you have for our team about this process.

    Contact Name*







    Municipal Manager (if this is the same as the contact, place an *)*







    Address*