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2024 Medicare Health Fair Registration Form

This question requires a valid email address.
This question requires a valid date format of MM/DD/YYYY.
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5. Please select which Priority Health Medicare Health Fair Event you are registering for. *This question is required.
6. Are you currently enrolled in health insurance through Priority Health? *This question is required.
7. As a Priority Health member, you are eligible to receive select health screenings (HbA1C test) and vaccinations (Pneumonia, Flu, Covid-19) by Corewell Health Providers during the health fair. Are you interested in registering for screenings and/or vaccinations?

Health screenings are an important part in maintaining your health. Screenings may help prevent illnesses, disease, and other health problems, or detect illness at an early stage when treatment is likely to work best.
  *This question is required.
 
7. Please select which screening and vaccinations you are interested in, select all that apply: *This question is required.
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