Health Screening Registration 2026

Health Screening Registration

Klamath-Trinity District Office | Sept. 17, 2026 | 7:00 - 9:30 a.m.

Use this form to register for the NCSMIG health screening on Sept. 17 at Klamath-Trinty Elementary District Office. Questions, contact Jennifer Burger in the NCSMIG office at jburger@hcoe.org or (707) 445-7148.

Your Name

First NameLast Name

School or District

E-mail

Phone Number

Area CodePhone Number

Time Slot

Select a time slot for your screening. Each slot is 15 minutes; if a time is grayed out, it means that timeslot is full.

Select a Time Slot