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Community Health Event Request Form

Huntsman Cancer Institute values the people and organizations who are committed to improving the health of our communities, families, friends, and neighbors. We are excited to support your efforts and to provide resources and health education about cancer risk, prevention, and care.

In response to the COVID-19 pandemic, all participation at in-person events will be reviewed individually.

For all events, we encourage that:

Participants who feel sick or have recently tested positive for COVID-19 stay home
There is sufficient space to practice physical distancing
Health and safety measures are in accordance with city and state guidance

To better serve you, please provide us with more information by filling out the Health Event form below. To be considered, requests must be received at least 30 days prior to an event. Please allow 5-7 business days for a response.

Name of Group or Organization

* must provide value

Group or Organization Website

* must provide value

Contact Name

* must provide value

Phone number

* must provide value

Email Address

* must provide value

Address

Address 2

City/Town

State/Province

Other

ZIP/Postal Code

Event Name

* must provide value

Event Date

* must provide value

M-D-Y

How many people are expected to attend?

* must provide value

Event Start and End Time

* must provide value

Event Description

* must provide value

Expand

Describe the general audience of this event (i.e. LGBTQ+, American Indian, Hispanic/Latino, seniors, teens). You can list multiple where applicable.

* must provide value

Expand

Topic/Cancer Focus (Select all that apply)

Breast Cancer

Cancer Prevention and Screening

Cervical Cancer/HPV Vaccination

Clinical Trials

Colorectal Cancer

Head and Neck Cancers

Lung Cancer/Radon

Prostate Cancer

Skin Cancer

Language of Requested Services/Materials

English

Spanish

Both

reset

Check the items you are able to provide

Table

Chairs

Power access

Canopy (for outdoor events)

Hand sanitizer

None of the above

Check the exhibits you are interested in

Giant Inflatable Colon

Mini Inflatable Colon

Cancer Prevention Pop-up Sign

Cancer Screening Pop-up Sign

Skin Scopes

Question Wheel

Event requests are subject to cancellation within 10 days of the event date, in accordance with current COVID-19 and public health notices, guidelines, and the health of staff.

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