Note: submission of the request is not a confirmation.

    If school, will kids come with teacher for: Set amount of timeJust "fly by"

    Will it be indoors? yesno

    If not, will there be a tent provided? yesno

    Will there be tables and chairs set up? (displays need a 6’ long table each): yesno

    We would like to partner throughout the year, can we schedule one of the items below? yesno

    Check all that apply: Health related article in newsletter or websiteAllow us to post national campaign (i.e. “Diabetes Alert Day”) posters at your facilitySpeaker on health topic for employee lunch ‘n learn or support groupConsultation on food available to target audience (vending areas, cafeterias, mtgs)Can we join your health team meetings?

    Check all that apply: WIC, Women, Infants, and ChildrenHANDS, Health Access Nurturing Development ServicesHarm Reduction Needle Exchange program, NARCAN trainingPublic Health Clinic - Info only, STD, ImmunizationsEnvironmental Services - Info only, mosquito control, bedbugs, rabies, septic system tips, etc.