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English (US)
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Community Health Fair – Family RSVP
Tell us your household’s estimated attendance, interests, arrival window, and preferred assistance language (walk-ins are welcome!).
Your Name
*
Email
OPTIONAL: for important event updates only
Phone Number
OPTIONAL: for important event updates only
Format: (000) 000-0000.
How many people might attend, including yourself?
Number of adults (18+)
*
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Number of children (under 18)
*
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Total expected attendees
Which services would you like to register for you and your family? (Select all that apply) - NOTE: Services marked 🔹 require more time. Signing up here will grant priority service
*
Children's Services - Development, Special Needs
Community Resources / First 5
🔹 Dental Services - Cleaning
Health Screenings - Blood Pressure, BMI, Glucose, Anemia Testing
🔹 Hepatitis B Testing & Vaccine
🔹 Massage Therapy
🔹 Medical Consultations & Ultrasound - Adult
Medical Consultations & Ultrasound - Children
🔹 Physical Therapy - Consultation
Vision Screening - Children's Vision, Adult Reading Glasses
Not sure yet
Around what time do you think you'll arrive?
9:00–11:00 AM
11:00 AM–1:00 PM
1:00–2:00 PM
Not sure yet
What language would you prefer for assistance?
English
Vietnamese (Tiếng Việt)
Spanish (Español)
Other
RSVP
Should be Empty: