Resource Request Form

To request resources for your student group/organization, classroom, or residence hall, please fill out and submit the form below. You will be contacted by a Campus Health Peer Health Advocate approximately two business days after submitting your request to confirm your submission.

Contact to ask questions:Dana Carpenter, Program Coordinator at dlcarp02@louisville.edu or 852-6784 or Email Health Advocates

Today's Date

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Person Requesting Resources

Name (Required)

Email (Required)

Phone Number (Required)

Organization

Position (Required)

Check all that apply.

RSA officer/member

RSO officer/member

Faculty

Other

Other Position

Resources (Required)

Choose the materials that you would like to request from the dropdown

Campus (Required)

Belknap/HSC

Belknap
HSC

Why do you need these materials? (Required)

Submit this form by clicking submit button provided or
to contact by phone: 852-5429

You will receive confirmation or request for more info in 2-3 business days.

THANKS for your interest in health promotion !!!

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Resource Request Form

Person Requesting Resources

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