Request for the Florida Department of Health in Orange County
Participation in Community Outreach Events

To request the Florida Department of Health in Orange County’s participation in a health fair/community outreach event, please complete this form. Submission of this form does not guarantee the participation in your upcoming event. Participation is based on staff availability and focus areas.
Please complete.
Date(s) requested:
Event Name:
Purpose of Event:
Contact Name:
Contact Information:
Sponsor Organization:
Event Date:
Event Start/End Time:
Setup Time:
Event Address:
Anticipated number of attendees:
Event target area:
Is the event inside or outside? If outside, will shade be provided?
Will tables & chairs be provided?
Is there a registration fee? If yes, what is the amount?
Request for education material or staff representation from DOH-Orange?

Florida Department of Health in Orange County
Vision: To be the Healthiest State in the Nation