Community Event Request Form

* 1. (Please read all instructions carefully.)
It is our goal to meet the needs of our community. We may not be able to accommodate all of the requests we receive, however, we will review event requests. Please see below for qualifications and eligibility. We will be in touch within 4-5 business days with follow-up information.

Notice of event guidelines
Accountable Communities can better accommodate your request if it is received at least eight weeks prior to the event. Please be advised that submitting a request eight weeks prior to your event does not guarantee that we will be able to accommodate your request.

Site requirements
To ensure the safety and privacy of our participants the following are mandatory requirements for events:
• Minimum of two tables and six adult-sized chairs
• Adequate lighting 
• Event area must be set up in a space conducive to protecting the privacy of those persons participating
• Event area must be clean and the facility must have clean restrooms.

If these requirements are not met, we reserve the right to cancel participation in the event.

Promotional materials
All promotional materials must be reviewed by Prisma Health prior to distribution.

**Disclaimer: Accountable Communities will assign the mobile unit to events based on services requested and information provided in event request form. **

If Accountable Communities is unable to attend your event, we may be able to provide information regarding our programs and services.