Would you like for us to participate in your Health Fair/Expo? Yes No Would you like for us to organize & implement your Health Fair/Expo? Yes No What date are you planning to have the event? * JanFebMar AprMayJun JulAugSep OctNovDec 12345678910111213141516171819202122232425262728293031 Would you like for us to provide glucose screening to the community participants? Yes No Would you like for us to provide cholesterol screening to the community participants? Yes No Would you like for us to provide Blood Pressure Screening to the community participants? Yes No Would you like for us to present a health care topic to the community participants? Yes No What other health related screenings or topics are you interested in? How many people in the community are you expecting to attend your event? Please Provide us with your Name, Address, Telephone Number * Please provide us with your e-mail address. * Other: Please let us know if you have additional questions. How did you hear about us? Created by KReative Health Solutions: All Rights Reserved
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