Native American Health Wellness Event

Native American Back to School Fair

in collaboration with Gorge Native American Collaborative August 23, 2024
Please fill out one form per patient.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Do you need transportation?*

YesNo
All services will be performed at Celilo Park (at Celilo Park Rd, The Dalles, OR 97058)
Type of Appointment

Friday, August 23, 2024 - Well Child Check (WCC)Friday, August 23, 2024 - Sports PhysicalsFriday, August 23, 2024 - Diabetes Care (if you have questions about your diabetes management, medications, and blood sugars.)Friday, August 23, 2024 - Diabetes screening and pre-diabetes
Should be Empty:

Native American Back to School Fair