Healthy Living Practices Submission Form

Contact Information (Your contact information will be viewable to other users) Expand/Collapse


Upload files (pictures, brochures, flyers, etc.)

Document Uploader Document Uploader Document Uploader
Image Uploader Image Uploader Image Uploader

Organization Type

Healthy Living Practice (Your contact information will be viewable to other users) Expand/Collapse

Date Range

Type of Practice: (Select all that apply)

Target Age Range (select all that apply)


Race/Ethnicity (select all that apply)

Counties Served (select all that apply)

Project Service Type: (Select all that apply)

Project/Program Content Area

Project/Program Care Team Target Population

LiveHealthyPA Healthy Living Practices - Disclaimer

By submitting a Healthy Living Practice to you agree that:
  1. All submissions shall become the property of DOH and DOH may use such submissions in any manner DOH deems appropriate for purposes and maintenance of the LiveHealthyPA website.
  2. The Pennsylvania Department of Health (DOH) has the sole and exclusive right to edit the text and resize any photos as needed.
  3. DOH is under no obligation to publish your submission.
  4. DOH may use your name, text image(s), and other uploaded materials as featured content in any medium whatsoever, including, any affiliate publication and in promotional and advertising and any derivative thereof, without cost or remuneration of any kind to the submitter.
  5. You warrant that you have the right or have secured any and all rights necessary to grant DOH the forgoing right and that the publication is not a violation of any existing right, including without limitation copyright or privacy right.
  6. You agree to hold the Commonwealth of Pennsylvania (including DOH) its officers, agents and employees, harmless against any and all claims, demands and actions based upon or arising out of any activities, and shall, at the request of the Commonwealth, defend any and all actions brought against the Commonwealth based upon any such claims or demands arising from or in connection with any use of the submission, including text, images(s), and other uploaded materials.
  7. You certify that you are 18 years of age or older.

Your submission will not be considered without the following information: Your Name, Address, Email and Telephone number.