Outreach Request

Services

Information Table

Well suited for health fairs, community walks/runs, or similar set-up, our Health Promotion team can provide materials and resources to distribute to community members while educating them on the selected health topic.

Presentation

One-time presentation tailored to your classroom, church group, organization, or other group setting.

Free HIV/STD Testing

Community-based testing for HIV and other STDs are available for events and organizations in New Hanover County. Please visit our Free HIV/STD Testing page to learn more about this program.

Request an Outreach Event

  1. Contact Information
  2. Audience Information
  3. Service Requested
  4. Please select the service being requested.*

    See descriptions regarding accommodations needed for services to be considered.

  5. Please also include the names of any additional agencies you will be inviting to your event. This information will assist Public Health staff in planning and preparing for your event.

  6. Event or Presentation Information
  7. Event Space*
  8. Topics of Interest
  9. If requesting an information table or presentation, please select up to 3 topics of interest*
  10. Equipment to be Provided by Event Organizer
  11. Please select the equipment you will provide for Public Health staff at the event location*
  12. Advertising Information
  13. Advertising Method(s) - Please select all that apply*
    • Accepted file types: jpg, gif, png, pdf, doc, docx, ppt
    • Maximum file size: 2 MB
    • A maximum of 5 files may be uploaded.
  14. Additional Information
  15. Outreach Site Selection Policy
    • Event requests must be made in writing at least one month in advance.
    • Services offered will be mutually agreed upon and confirmed prior to the event.
    • Services offered may vary depending on the event and availability of equipment and supplies.
    • Public Health participation is dependent on the availability of Public Health staff.

    Please note: submission of this form does not constitute a confirmation of Public Health's participation in your event. A Public Health staff member will contact you to discuss your event or presentation request, and the availability of staff for your event.

  16. I have read the Outreach Site Selection policy listed above.*
  17. First

  18. Last

  19. Leave This Blank:

  20. This field is not part of the form submission.