All of Us Journey Event Request Form

The All of Us Journey visits communities to raise awareness about the All of Us Research Program and provide access to enrollment through on-site devices and the enrollment center vehicles that serve as mobile enrollment sites. The mobile exhibits feature hands-on activities for visitors to learn about the benefits of participation.

The East and Central Region All of Us Journeys are equipped for visitors to join the program and provide physical measurements, blood, and urine samples onboard.
- Please note: Due to logistical considerations and requirements, the East and Central Journey will stay at the same location for 4-5 days during weekdays (M-F) to maximize PM&B opportunities.
The West All of Us Journey provides participants with awareness, education, and access to enroll and order salivary kits.

Please note that the Journey's schedule is confirmed 60-90 days in advance. We recommend that you submit your event opportunity as far in advance as possible even if all details are not yet finalized.

If you have questions please contact: Tom Bever, Sr. Program Manager tbever@montagemarketinggroup.com

Regional Map Coming Soon

Tell us about yourself:

Name

First NameLast Name

Email

example@example.com

Phone Number

Area CodePhone Number

Name of Organization

Are you an All of Us Research Program Consortium member?

YesNo

If Yes, Select your group

If yes, Name of NIH Engagement Officer or Program Officer:

If CPGI Partner, What is the name of CPGI org that you are affiliated with:

Select the All of Us Journey that you would like to host

How did you hear about the All of Us Journey?

Tell us about the event opportunity:

Is this an existing event?

YesNo

Is your organization the main event host?

YesNo

Event Name

Event Type

Intended Purpose of the Proposed Event:

Expected Event Demographics:

Event Start Date

Date

Event End Date

Date

Event location:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Tell us about the event: goal, expected attendance, promotional efforts, and any other information that can help us understand the opportunity.

Special Request (Interpreters, language needs, etc).

How will you promote the All of Us Journey's visit?