DCBOH Men’s Health & Wellness Fair: Screener & Vendor Interest Form
Thank you for your interest in the DeKalb County Board of Health (DCBOH) Men's Health and Wellness Fair.
The mission of the fair is to connect the men of DeKalb County to medical care through screenings, education, and referrals. This fair will provide a valuable service to the community so that men are better equipped to care for themselves and in turn care for their families and communities.
Anticipated attendance is 300.
Please complete this form by Friday, April 19th, 2019.
If you have questions, contact the DeKalb County Board of Health at 404-508-7847 or
Saturday, June 29, 2019
11 a.m. to 3:00 p.m.
Georgia Piedmont Technical College
495 North Indian Creek Drive
Clarkston, GA 30021
Completion of this interest form does not guarantee or confirm participation in the health fair. Final decisions will be made by the DeKalb County Board of Health Men’s Health & Wellness Fair Committee to ensure compliance with our stated mission.
Note: Confirmed vendors and screeners will be provided with one 6 or 8 foot table and two chairs.
Are you registering as a Vendor or Screener?
Vendor: A person or company that sells/promotes goods or services.
Screener: Someone who tests or examines for the presence of disease or infection.
Booth ID Name (if different from Company Name / this is how you will be recognized)
Type of Health Information provided (if applicable):
Type of Service to be provided:
Physical Health Promotion Related Services (Chronic Disease, Nutrition, Fitness)
Access to Care Related Services (Hospital and Clinic Resources, Insurance & Health Coverage)
Behavioral Health Related Services (Counseling, Substance Abuse, Mental Illness)
Supportive Services (Housing, Legal Aid, Financial Literacy, Employment/Career)
Services for Targeted Groups of Men (Refugee, Disabled, Veterans, Latinos)
Youth Services (School board, youth-serving organizations, after-school programs)
Food Services (restaurants, health eating demonstrations)
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