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Allegheny Quits for Life Partner Form
What is Allegheny Quits for Life? It's a partnership with community organizations, led by Tobacco Free Allegheny and the Allegheny County Health Department, to promote the free cessation resources available to Allegheny County residents. We're looking for organizations who will include cessation resources, like the PA Free Quitline, in any events they may be doing November 12 - 18. We're looking for organizations who will share resources on their social media pages. Share your information below and we'll provide you with resources you can include at your event.
Contact Name and Title
Organization
Address
Phone Number
Email
Are you able to share your organization's logo with Tobacco Free Allegheny and Allegheny County Health Department to use on partner documents (flyers, websites, etc.)?
Attach logo here (multiple logos are allowed)
Is your organization on social media?
Please include usernames for any above accounts for tagging.
Are you currently planning to host any events between November 12th and November 18th?
Events can be submitted here.
Are you currently a Live Well Allegheny Partner?
If no, are you interested in coming one?
Are you a member of the Tobacco Free Allegheny coalition?
If no, are you interested in being added to our mailing list?
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