Public Health K-12 School Support Request

Please complete all sections and discuss directly with your health office personnel. The specific needs for your school determine the scope of work; we will deploy MRC volunteers or MCDPH staff accordingly.

School Information

Scheduling Information

Days of the Week Support is Needed


Primary Contact for Staffing Requests

Pease NOTE: A copy of this information will be emailed to the address you specify below.

Volunteers/Staff Information

Pease check all that apply.
Specialized Skills
Basic Support

Needed Information