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PROMISE HEALTHCARE EVENT REQUEST

Promise Healthcare is dedicated to cultivating strong relationships within our communities. Are you hoping to have Promise Healthcare's staff at your upcoming event? Please fill out the request form below, and you will be contacted. 
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Questions?
Please contact Scott Dean, 217-600-7000 Ext. 451
Or email sdean@promisehealth.org

 

Contact Name*:
Contact Organization*:
Contact Email*:
Contact Phone Number*:
Name of Event*:
Date of Event*:
Event Backup / Rainout Date, if applicable.:
Event Start Time*:
Event End Time*:
Name of Location for Event*:
Event Location Address*:
What time should Promise Healthcare staff arrive?*:
Expected Event Attendance*:
Event Information:
Will a table be provided, or does PHC need to bring one?:
Event Link, if available:
Event Files, if any:
How did you hear about us?: