Media Requests

Providing communications services to our members

The Health Collaborative is proud to offer communications services to our members, and to act as Public Information Officer on behalf of our region’s Disaster Preparedness Coalition.

Please complete the form below and a member of our team will be in touch within 48 hours.

Media Request Form

Contact Name*
First Last
Contact Organization*
Contact Email*
What type of media are you requesting?*
Key Message*
What is the information you would like to share?
Timing*
What date should it be released?
Who should be included?
Consider quotes and interviews. Include name, title, organization, email, cell phone number.
Are pre-approved quotes available?
- Yes
- No
Data
Note: The data you are providing for this communication must be must be reviewed internally to ensure that any data release is in compliance with relevant federal, state, and local laws including HIPAA. Please be specific in terms of data source, population, demographics, geographic level (i.e. – county, zip code, etc.).
File Upload
Browse and upload supporting data files here.
Drop files here or

Accepted file types: jpg, png, pdf, docx.
Do you have a role on the Region 6 steering committee or a workgroup?*
- Yes
- No
Approval process
Describe your organization's approval process and expected timeline.
Other details
Is there any other information needed to produce this content?
File Upload
Please include any other relevant documents, photos, logos, etc.
Drop files here or

Accepted file types: jpg, png, pdf, docx.

DISCLAIMER: Please allow 24-48 hours for a THC staff member to confirm your request. Once confirmed, please allow 3 business days for a draft, 5-7 business days for total turnaround, and at least 2 business days (from completion) for Spanish translation.