Event Request

GNR Public Health’s mobile Community Outreach Team provides a wide variety of services to the community. We offer these services at health fairs, schools, churches, police departments, and other organizations in Gwinnett, Newton, and Rockdale counties.

For your upcoming event, we can provide health screenings, educational presentations, COVID and NARCAN®️ kit distribution, as well as certain vaccinations for routine purposes, school attendance, or even employment.

To request our mobile health services please fill out the form below. To allow for proper event coordination, please submit your request at least 20 days in advance. Our team will review submitted requests and based on the information included in the Event Request Form, will let you know our availability. You will be notified of the decision within ten business days after submission.

Organization Information
Organization/Event Host Name:
Organization/Event Host Address:
Organization/Event Host Phone:
Contact Person Name:
Contact Person Phone:
Contact Person Email:
Event Information
Type of Event:
Event Name:
Event Address (if different from above):
Event Date

-

Month

-

Day

Year
Start Time

:

Hour

Minutes
End Time

:

Hour

Minutes
Target Event Audience and number of participants expected:
Topics you would like the Health Department to address:

Will the health department need to provide a table and chairs?
NoYes

Is the event indoors or outdoors?
IndoorsOutdoors

Will we have access to a power source?
YesNo
Additional Information:

Event Request

Organization Information

Event Information