Community Event Request
Thank you for your interest in partnering with the Anne Arundel County Department of Health for your upcoming event. We offer our display resources to public events, such as health fairs, in Anne Arundel County in order to inform the community about important health topics. To request that the Department participate in your event or provide materials, please complete the event request form at least two weeks prior to the event.

All requests are reviewed once received. Our ability to honor your request is based on staffing and date. The form is a notification to the Public Affairs Specialist and not a confirmation that the Department will participate. Depending on those items, we may be able to provide staff and materials or just materials. If we only are able to provide materials, you may have to coordinate a pick-up date and time with the Public Information Office.

If you have any questions or cannot fill out the online form, call 410-222-3501 or 410-222-4508.
First Name: *
Last Name: *
Phone Number: *
Email: *
Sponsoring Organization Information:
Organization Sponsoring Event: *
Type of Sponsor
Event Name:
Event Location:
Street Address:
City:
ZIP Code:
Event Date: *
MM
/
DD
/
YYYY
Response Deadline:
MM
/
DD
/
YYYY
Event Set-up Time:
Time
:
Event Begin Time:
Time
:
Event End Time:
Time
:
Number of Attendees Expected:
How many years have you held the event?
Audience Description (County residents, age range, special interests, language, etc.):
The event will be held (check all that apply):
Rain Date:
MM
/
DD
/
YYYY
Tables and Chairs Supplied?
Clear selection
Brief Description of the Event (include any website link):
Fee to Participate?
Clear selection
Is event in a smoke-free and vape-free environment? *
Additional Event Notes:
Areas of Interest:
Behavioral Health (Check all that apply.)
Diseases and Immunizations (Check all that apply.)
Environmental Health (Check all that apply.)
Infant, Children and Adolescent Services (Check all that apply.)
Uninsured or Low-Cost Health Care (Check all that apply.)
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