Community Health Guide & Referral Pad Request
If you are an organization or agency in a position to refer youth, families and individuals to resources, we are happy to provide you with a hard copy of the health guide or referral pads. We will contact you via email to arrange for you to pick up your copy or copies from Eaton RESA. In some instances, we maIf you are a school, we have staff that may be able to make deliveries.
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Email *
Agency or Organization Name *
Agency Addresss *
Contact Name *
Email Address for agency contact *
Number of Copies of Health Guide requested (hard copies are for staff use only. The public can access the guide online).  *
Would you like tear off one-page summary referral pads for Eaton, Ingham or Clinton County?  Each pad has 50 referral tear-off sheets.  Pick up is encouraged at Eaton RESA in Charlotte. If you cannot pick up, please let us know so we can coordinate delivery. Please say for what county and how many pads you want. We will also need the address and name of  who to make the deliver to as well as open hours for drop off.  Only if you are a school that is part of our SHIFT grant, will you be asked to report back how many sheets you hand out. In 2024, no reporting is required for all others who hand out referral sheets. *
A copy of your responses will be emailed to the address you provided.
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