Request Health Screening or Education at Your Facility

What sevice are you seeking to host? *select all that apply* * Required

Health Screening

Health Education Seminar

Facility Name

Name of Contact Person

Email

Facility Website

Address

Code

Phone

Desired location of screening or Seminar?

How many participants do you anticipate serving?

Select proposed date of screening *date must be at least 45 days away* * required

Thanks! We’ll get in touch soon!

The Gbleehai Foundation
We Care

4025 Brandywine St. NW Suite 2 Washington, DC 20016

The Gbleehai Foundation is a 501c(3) tax exempt organization, IRS section 170(b)(2)(iii) for both federal and state tax purposes.

Donations will be secured through givebutter and accreditation listing is with Givebutter and Guidestar

Tax ID Number: 87-1110968

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