Community Health Outreach Program

HEALTH FAIR REQUEST FORM SURVEY

Instructions:
Please complete the form below. This form can be used to request services from the Miami Dade County Health Department solely, as well as from the Consortium for a Healthier Miami-Dade. Those interested in participating will contact you directly to discuss their availability.










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General PublicCollege & UniversitySenior GroupsK-12 StudentsHealth ProfessionalsFaith-basedFamilyCorporate SettingOther

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0-1819-2425-3536-5051-6970+



Miami Dade County Health Department OnlyHealth Dept and Consortium for a Healthier Miami Dade



































Site Accommodations for Health Providers (Vendors):















Other Information:













DISCLAIMER:
The Miami-Dade County Health Department and the Consortium for a Healthier Miami-Dade are NOT endorsing any activity by disseminating this form. The purpose of this form is only to disseminate information about community health fairs and provide a forum for collaboration and partnerships between interested organizations. It is NOT the responsibility of the Consortium to coordinate or determine if there is any sponsorship exclusivity related to each community health fair. Any questions regarding the event must be directed solely to the event planner.

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