PEDIATRIC OUTREACH PARTNERSHIP

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We partners with schools and organizations that serve low income families to provide outreach clinical care and vaccination to your families and children. We want to keep your child healthy and limit their number of absentee days from school.
Once you submit the form you will be contacted by our volunteer coordinator within 24 hours. If you are unable to get an answer in timely fashion please call us at 843-352-4580 ext 3

Name of Organization *

Name of contact person ( first and Last name) *

Email *

Phone Number *

What would like us to partner regarding: *

Well check visit

Vaccination

Food program

All

Other:

Address of school/ organization you would like us to visit *

Date *

YYYY

Submit

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