Mentally Healthier Workplaces Pledge Submission

It’s fantastic that you are committed to creating a mentally healthier workplace.

Please complete and submit the pledge below to get started on your journey. You will be asked to upload your business logo for inclusion on our Pledge Wall and in social media posts, subject to approval by Healthier Work.

Please note: Only businesses/organisations located in the Australian Capital Territory are eligible to participate in this pledge program. You will need to complete the online self-assessment tool and submit your action plan to Healthier Work within three (3) months of submitting this pledge to continue with the program.

On submission of your pledge, Healthier Work will contact you to assist you in your next steps, as needed. You can start your online self-assessment as soon as you have submitted this pledge.
Are you a key decision maker in your organisation?*
- Yes
- No
We recommend you gain approval from your key decision maker before you continue.

About you
First name*
Last name*
Telephone*
Email*
Job Title*
About your Organisation/Business
Organisation/Business name*
Address Line 1*
Address Line 2
Address Line 3
Suburb/city*
State*
Postcode*
Organisation/Business size*
Number of employees in the Australian Capital Territory*
Sector*
Please specify
Sub Sector*
Website URL
Description*

In 50 words or less, please describe what your business/organisation does (for inclusion in your Pledge Wall acknowledgement)
Terms and Conditions*
- I am authorised to submit this Mentally Healthier Workplaces Pledge on behalf of my organisation. I understand that my organisation will need to complete the online self-assessment and submit our action plan within three (3) months to continue with the pledge program.
Logo*
Please attach your organisation/business logo to be included on the online Pledge Wall and in social media posts, subject to approval by Healthier Work. Logos should be in jpg or png with recommended dimension of 320px x 320px and no larger than 3 MB.
Accepted file types: jpg, png.
Facebook
If your workplace has a Facebook handle, please provide this so we can tag you in social media posts.
How did you hear about the Mentally Healthier Workplaces Pledge?
- Healthier Work website
- Healthier Work event
- Healthier Work social media/e-newsletter
- Internet search
- Mentally Healthier Workplaces launch event
- Word of mouth
- WorkSafe communications/event
- Other
If ‘other’, please specify:

Healthier News