Cuba Community Health Fair Invitation

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                                   Cuba Community Health Fair
              I am pleased to extend an invitation to you and your practice to participate in the
              upcoming community-wide Health Fair on May 8th, 2010 from 9am – 3pm at the
              Resource Center, 412 N. Franklin Blvd., Cuba, Missouri 65453. The purpose of
              the Cuba Community Health Fair (CCHF) is to increase health awareness
              through education and prevention. The event is being organized as a service
              project by Bill Right, LLC. We welcome local sponsors, participants and

              This Health Fair will provide a valuable service to our community. Your
              participation will help us in this effort. We want to provide basic health
              screenings, immunizations, and blood pressure and glucose checks as well as a
              variety of informational booths designed to help the community become aware
              of the many health-related programs, services, and providers located in our
              surrounding community.

              The Cuba Community Health Fair will be open to both adults and children. We
              anticipate an attendance of approximately several hundred people. We are asking
              that each participant provide some form of information/educational materials,
              demonstration, or service for the Health Fair.
              If you have other expertise you would like to share with the organizing of the
              Health Fair, please contact me or indicate on the enclosed application form.

              To facilitate our planning, please return the enclosed application form no later
              than 5/5/2010. If you have any questions, do not hesitate to contact me, Robert
              Tash at 573-205-5803. I am excited about bringing this Health Fair to our
              community and look forward to your participation.

              Robert Tash, CCHF Chairman

412 N. Franklin Blvd., Suite 203                                                 Office: 573-205-5803 Fax: 888-737-5608
PO Box 650                                                                                  Email:
Cuba, MO 65453                                                                              Website:
           Cuba Community Health Fair Participation Application

Thank you for your interest in the CCHF scheduled for May 8, 2010 from 9am – 3pm. The
fair will be located outside (weather permitting) in the front parking area at the Resource
Center 412 N. Franklin Blvd. Cuba, Mo 65453. (Old Cuba Nursing Home)

Contact Information:

Robert Tash – Fair Organizer

PO Box 650, Cuba, MO 65453

Phone 573-205-5803 (Cell 843-817-3232)


RSVP: 5/5/2010

All participants will provide staff/volunteers and resources for their booth. We recommend
a canopy, folding table and two folding chairs. Electrical service with a duplex outlet will be
provided for each participant if requested.

All fields marked with * are required.

General Information

Provider / Practice Name: *

Service / Screening Presented:*

Contact Person:*

Contact Phone Number:* (ex. 000-000-0000)

Contact E-Mail Address:*

Electricity Required? Y/N

    Cancer (Breast, Cervical or Colon)                 Prenatal Care

    Cardiovascular (Heart) Disease                     Public Health Emergency Preparedness

    Diabetes/High Blood Sugar
                                                       Sexually Transmitted Diseases (STDs )
     Health Insurance for Pregnant Women and       and HIV/AIDS
Children (MCHP)
                                                        WIC Foods for Women, Infants and
     Lead Testing (Environmental and in            Children
                                                       Substance Abuse (Alcohol, Drugs and
    Mental Health                                  Other Addictive Substances)
    Nutrition/Eating Healthy                           General Health Department Services


     Physical Activity, Exercise and Healthy

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