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Healthy Arizona Worksites Program Award Application
Before you apply for the Healthy Arizona Worksites Award, your company should have already completed the following:
1. Attend a HAWP 101 Training
2. Complete the Centers for Disease Control (CDC) Worksite
3. Begin a HAWP Worksite Health Improvement Plan
You can find these items, including a schedule of upcoming HAWP 101 trainings, at HealthyAZWorksites.org.
You may want to
print this form
, review it with your team, and gather your supporting documents before proceeding. This application may take up to an hour to complete. However, you
be able to save your responses and return to the form prior to submitting it.
The Healthy Arizona Worksite Award is awarded at four different levels. Determine the award level that represents your Worksite Health Improvement Plan.
Attendance at the Healthy Arizona Worksites Program Training
Worksite Wellness Champion or Champion Team
Letter of business leadership support and pledge to participate
Completion of CDC Worksite Health ScoreCard
Completion of basic Worksite Health Improvement Plan
At least one goal with related objectives and intervention strategies is required for this award
All Copper Award Criteria must be met
One additional goal (2 total) with related objectives and intervention strategies based on data are required for this award.
Additional Data Requirements, select one:
- Employee interests data
- Environmental, organizational or cultural survey
- Management survey
- Health risk appraisal
- Biometric screening or collected biometric data
- Other data collection tool used to inform the design of your wellness program may qualify, please ask us for approval
Meet the Silver requirements listed in the Supportive Policies and Environments Section
All Silver Award criteria must be met
One additional goal (at least 3 total) with related objectives and intervention strategies based on data are required for this award. Must be able to demonstrate outcomes and the tracking and evaluation of those outcomes.
One additional Data Requirement (At least 2 total) see list in Silver Award Criteria
Meet the Gold Requirements listed in the Supportive Policies and Environments section.
Must be current Gold Awardee and have a current CDC Scorecard completed
Submit an outline of the healthy community partnership strategy that has been in place 6 months to one year or more
Submit a narrative of 1-3 specific initiatives (500 words max)
Commitment to demonstrate measurable results in improving health. Submissions should detail the impact and evaluation methodology from the project that occurred in the past 24 months.
Submit all outcome data to date, examples of promotion/marketing, videos, surveys, etc.
What award level are you applying for?
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