Name of organization or church
Name of person submitting request
Event date & time
Number of attendees expected
Is the event in-person or virtual?
If in-person, are table/chairs provided?
If so, what length is the table?
Is the event indoors or outdoors?
If outdoors, do you provide a tent?
Please indicate below any services you want to request for your event.
Education and Information:
Alzheimer’s Research & Memory Assessment Info
Bariatric Weight-loss Services
COVID-19 & vaccine education
Dealing with Serious Illness & End of Life Care
Diabetes & Nutrition
Drug Overdose Reversal Training
Durable Medical Equipment Information
Faith & Diversity
Hands-Only CPR Training (2-minute training)
HIV Prevention & Maintenance
Hospital Safety for Inpatients – What to Expect
Infection Prevention & Sepsis Recognition
Medical Financial Counseling
Orthopedics & Pain Management
Spirituality & Health
Stroke Prevention & Education
If you are requesting cancer information, please specify type of cancer.