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Salt Lake Valley Health Department

SLVHD | Weigh Active and Healthy

Registration Form

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First Name
Last Name
Address
 
City
Zip
Phone
Email

 

Names of people in your family who would also like to participate in
Weigh Active and Healthy: A Lean Initiative.

Name
  Name
Name
  Name
Name
  Name

Where did you hear about this program?

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Would you like emails sent to you with healthy tips and recipes?
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  • After clicking "Submit" at the bottom of the page you will receive a confirmation page, which you can print

  • Salt Lake Valley Health Department
    Bureau of Health Promotion
    2001 South State Street Suite S2400
    Salt Lake City, UT 84190

    801-468-2738