D5 Community Health Fair Registration

D5 Community Health Fair Registration
Welcome to the D5 Community Health Fair Registration

We are excited to invite residents living in Moreno Valley, Nuevo, San Jacinto, Hemet, Calimesa, Banning, Beaumont, Cabazon, Cherry Valley, San Timoteo & Reche Canyon to join us at the D5 Community Health Fair at Vista Del Lago High School on Saturday, April 25, and Sunday, April 26.

Community members will have the opportunity to receive free services such as dental care, vision, haircuts, and more. Please note that each patient may receive one service per day, so we encourage you to choose and prioritize the service you would most like to receive.

Services will be available from 8:00 AM to 4:00 PM each day. Space is limited, so we encourage you to register as soon as possible and share this opportunity with your friends and family. We kindly ask that you arrive 30 minutes before your scheduled appointment to ensure a smooth check-in and preparation process.

We look forward to serving you and our community.
Full Name*
Date of Birth*

MonthDayYear
Phone Number*
Email*
example@example.com
Which City Are You From?*
Services are reserved for District 5 Riverside County residents
Zip Code/Postal Code*
Participant ID Number*
(Phone # and Birthdate, No Spaces)
April 25, 2026April 26, 2026

Which Service Would You Like to Receive? (One Service Per Person Per Day)*
Services for Saturday (April 25, 2026)

Which Service Would You Like to Receive? (One Service Per Person Per Day)
Services for Sunday (April 26, 2026)

County of Riverside Supervisor - 5th District Dr. Gutierrez OfficeWord of Mouth (Friends/Family)Community (Church/Work)Health Plans (IEHP/Molina Health/RUHS)Social Media (Facebook/Instagram/Tiktok, etc)Other
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