Include Your 100% Smoke-free Restaurant
Are you a restaurant owner or manager in Polk, Dallas, Madison or Warren counties? Is your restaurant 100% Smoke-free? If so, please fill out the contact information below to add your 100% Smoke-free Restaurant to the Central Iowa Smoke-free Dining Guide! Thank you for your Smoke-free business, and for helping us Take Back Our Air in Central Iowa!

View the Smoke-free Restaurant Guidelines

Basic Information: Please fill out all fields... Name of Restaurant: Owner / Manager: Restaurant Address: City: State / Zip: / Restaurant Phone #:

Smoke-free Information: Please answer each question... Is your restaurant 100% Smoke-free?    Yes   No If your restaurant has a bar, is it also 100% Smoke-free?    Yes   No   No Bar If your restaurant has a patio, is it 100% Smoke-free?    Yes   No   No Patio May we publicly promote your restaurant as being 100% Smoke-free?    Yes   No Would you be interested in hosting an event at your restaurant location?    Yes   No Would you be willing to speak publicly about the benefits of Smoke-free dining?    Yes   No Would you like more information about the benefits of Smoke-free dining?    Yes   No

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