Health Fair Application Form

Health Fair Event Host Request

Please submit this form if you are interested in hosting or co-hosting a health fair in your community.

"*" indicates required fields

What audience are you hoping to serve during the requested health fair? General public, minority populations, aging populations, families with children, etc.
Requested Screenings * Required
Please note that we cannot guarantee all of the screenings you request will be available on your requested health fair date.
Requested Health Topics * Required