Health Fair Request

A stethoscope and a fountain pen on top of a medical form

We are devoted to helping keep our communities healthy and informed. If you are having a health fair, and would like materials or a representative for an event, please complete the form below at least 30 days prior to your scheduled event for your request to be considered. If you have any questions, please call 713.439.6093. All services are based on availability.

Requester Information
Enter Organization Name.
Enter Event Name
Please Enter the name of the Contact Person
Enter Event Date
Open the calendar popup.
Enter the Event Address
Please enter your Phone number
Please enter your email address
Enter City
Select State from the List.
Please enter the event zip code

Please check all that apply, Note: A minimum 100 confirmed participants is required for mobile units.

Please Check more then 1 box from the Type of Request.

Please Check more then 1 box from Target Audience.

Please Check more the 1 box from Language of Attendees.

Please select Number of Attendees from the list.

Please check 1 or more box from Requested Programs/Services.

Please enter details including purpose and special instructions for the event.
Enter the code shown above in the box below.