Request a Healthworks Health Fair

Name of Health fair event

Requested date/time of Health Fair

Requested Health Fair location

Address

City/Town

State/Province

ZIP/Postal Code

Additional details about location, including directions, room number, space description

Will Health Fair be indoors?

Yes

Will you provide tables and chairs, if necessary?

Yes

Is wireless internet available at requested location?

Yes

Will any vendor refreshments be provided?

Yes

How many attendees do you anticipate?

How will Health Fair be promoted among your employees?

Name

Phone

Please take a moment to include any additional comments you may have.