Form Center

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COVID-19

  1. COVID-19 Education Request

    Please complete this form if you or your organization would like a COVID-19 Education presentation for your staff or the community.... More…

  1. COVID-19 Vaccine or Testing Event Request Form

    Please complete this form if you or your organization are interested in partnering with Cabarrus Health Alliance (CHA) to host a... More…

EIM

  1. EIM Physican Nomination
  2. REACH Community Garden Initiative Application

    The Cabarrus Health Alliance is seeking faith-based organizations who have an interest in reviving or starting a community garden. At... More…

  3. REACH School Garden Initiative Application

    The Cabarrus Health Alliance is seeking elementary schools who have an interest in starting, expanding, or revitalizing a school... More…

  1. Nominate Your Neighborhood Store

    The Cabarrus Healthy Corner Stores (CHCS) program aims to increase the accessibility, availability and visibility of healthy items in... More…

  2. REACH Joint Use Agreement Initiative Application

    The Cabarrus Health Alliance is seeking faith-based organizations who are committed to promoting and supporting physical activity in... More…

Environmental Health Forms

  1. CHA Food Safety Advisory Group

    The next meeting for the CHA Food Safety Advisory Group will be Thursday, October 27, 2022. To participate in the meeting, simply... More…

General

  1. Community Events Request Form

    Use this form to request CHA's participation in your community event.

  1. Public Comments Request Form

    Please fill out this form prior to address the Cabarrus County Public Health Authority Board of Commissioners.

SEDI Forms

  1. Sample Form

    This is a test form....

Wellness Forms

  1. A FREE Diabetes Prevention Program - Clase para la prevención de la diabetes GRATIS
  2. Environmental Health Request for Information

    Septic System Research

  3. Inscripción a las clases de cocina

    Únase a nosotros para aprender a cocinar recetas rápidas, fáciles y saludables. Junto a nuestros chefs, explorarás nuevas habilidades y... More…

  4. Living Healthy with Chronic Disease Registration

    By completing the following form your interest will be noted and you will receive a follow-up phone call or email.

  5. Specialty Class Registration

    If you are interested in having a Specialty Nutrition or Cooking Class, please complete the information below. A staff member will... More…

  1. Cooking Class Registration

    Join us to learn how to cook quick, easy, and healthy recipes. Alongside our chefs, you will explore new skills and food that will you... More…

  2. Family Cooking Class Registration

    Join Chef Corey on a 4 week series to explore all the different ways to make chicken more exciting! Each class builds on the one... More…

  3. Kids in the Kitchen Cooking Class Registration

    Our young chefs will learn a variety of recipes through demonstrations and hands on activities to help them build lifelong skills to... More…

  4. Spanish Family Cooking Class Registration

    ¡Únase al Chef Milly en una serie de 4 semanas para explorar todas las diferentes maneras de hacer el pollo más interesante! Cada... More…

  5. Worksite Wellness Interest Form

    To learn more about our “Live Well, Work Well” Worksite Wellness program please complete the form below.