Request MHAM to Attend Your Health Fair or Event

To request MHAM to attend your health fair or event, please complete and submit the form below. A member of our staff will review your request and contact you with further information.

Please enter the following information:
* Name
 
* Email
 
* Phone
 
* Organization name
 
* Please describe your health fair/event
 
* Date and time of health fair/event
 
* Number of expected participants
 
* Is there a fee for MHAM to attend?
  Yes
No
If yes, please enter the fee amount
 
Additional needs or requests
 
Enter Letters For Verification
* Required Fields