Media Request Form

For media inquires, please fill out the following form completely.

The Health Department will work to answer most media requests within 1-2 business days. Some media requests that require research and data analysis may take 3-5 business days or longer.

Form

Date and Time of Request

Media Organization - Station - Paper - etc

Reporter Name

Reporter Email Address

Reporter Phone Number

What is the topic or subject of your inquiry

What prompted your interest in this topic

What are some of the questions you need us to answer (the more detailed the better)

What other informational sources have you consulted (are you familiar with this topic)

Security Code

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