International Community Health Screening Registration

Register for a community health screening visit.

Please share a few details so the team can prepare for your visit and support your preferred language.

Full Name

Email Address

Phone Number

Preferred Language

Screening Type

Blood Pressure Check

Diabetes Screening

Vision Screening

Dental Check

General Wellness Check

Preferred Time

Morning

Afternoon

Evening

Need an Interpreter?

Yes

No

Not sure

Anything we should know before your visit?

Consent

I understand this form is for registration only and does not replace medical advice.

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