Advocates of Health Award
Presented to the county Alliance with the most outstanding local community health project.

Areas to include in your application:
- level of alliance’s involvement
- level of involvement of local medical society
- level of involvement with other organizations, e.g. schools, libraries, other civic organizations
- number of individuals receiving services
- how the community was affected
County Alliance *
County President *
Phone *
Person Completing Form
If not county president
If you would like this project/program/event to be considered for another award category, please indicate which category(ies) below.
Please be sure to include all requested information for other category criteria.
In what type of community health project did the alliance participate? *
e.g., health fair or clothing drive
Did your medical society participate with you? *
If you worked with any other organizations, please name:
How many adults were reached with this program? *
How many children were reached with this program? *
Why did you choose this project for your alliance? *
Please describe the project or event. *
Was any follow-up done, or is any follow-up planned, to measure change in awareness and/or behavior? *
If yes, please describe:
If you wish to be considered for another award category, please include additional award criteria information here.
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