Health Education/Outreach Request

In our Health Promotion programs, trained health educators collaborate with partners throughout the community, such as work sites, schools, faith based community groups, and families to promote healthy lifestyles.

Health Promotion staff can provide workshops and presentations on a variety of topics promoting community health and well-being. We will be pleased to provide requested services for your organization or event, dependent on the availability of staff.

Services 

  • Information Table – See “Topics Of Interest” below.
  • Presentation – If you would like a one time presentation tailored to  your classroom, resource fair, employee fair, student organization, or church group, please complete the Health Promotion Outreach Request form below.
  • HIV/Syphilis/Hepatitis C Testing – Free testing in non-traditional settings. Testing space must be private and able to accommodate 3 adults, a table and 3 chairs. Air conditioned space is highly recommended. Grant funding to support this services or condom distribution is no longer available. 
  • Bike Safety Rodeo – Ideally designed for ages 5-12. Bike Rodeos are opportunities to educate parents and children about the safety aspects of riding a bicycle on streets and roads. The goal is to empower young cyclists with a minimal set of skills for on-road riding and teach them rules of the road.  A large parking lot area is needed to design a course that can be blocked off from all other traffic, along with volunteers to help man the course as kids ride and assist with helmet fittings and bike checks. Participants are required to wear helmets.

Requests must be submitted at least one month in advance of requested date to receive full consideration.

To download a PDF version of this form click here.

Request an Outreach Event

  • Contact Information

  • Contact Information

  • Audience Information

  • Service Requested

  • Event or Presentation Information

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
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  • Topics of Interest

  • Equipment to be Provided by Event Organizer

  • Advertising Information

  • Drop files here or
    Accepted file types: jpg, gif, png, pdf, doc, docx, ppt, Max. file size: 2 MB, Max. files: 5.
      A maximum of 5 files may be uploaded.

    • Additional Information

    • Continuing Wellness Activities

      In order to continue the wellness of participants after your event, we encourage you to implement a policy or a change in your physical environment that can enhance your work site, office, etc. Listed below are examples of some changes you may want to adapt after the event. Please check the applicable boxes or list other changes you are interested in making in your organization.

    • Outreach Site Selection Policy

      1. - Event requests must be made in writing at least one month in advance.
      2. - Services offered will be mutually agreed upon and confirmed prior to the event.
      3. - Services offered may vary depending on the event and availability of equipment and supplies.
      4. - 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.

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    • This field is for validation purposes and should be left unchanged.
    Health: 1650 Greenfield Street • Wilmington, NC 28401 • Phone 910-798-3500 • Fax 910-798-7834 • Human Services Fax 910-798-7824
    Environmental Health: 230 Government Center Drive, Suite 140 • Wilmington, NC 28403 • Phone 910-798-6667 • Fax 910-798-7815
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