KLM Day 20 Health Provider Registration

KLM Health Provider Registration Form

Health Provider Information

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Set Up Preference

Please list the services you will be providing.

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Prior Health Fair Participants: National Center for Missing & Exploited Children (NCMEC), Prince Georges Fire Department, Regional Transplant Consortium,  Scleroderma Foundation, The Hospices of the National Capital Region, Prince Georges Health Department, Washington Hospital Center, Southern Maryland Hospital Health Express Van, Hospice of Chesapeake, Vaccine Research Center, Sasha Bruce Youthwork, Congressional Glaucoma Caucus Foundation, Harrison Center for Career Education, Carefirst Bluecross Blueshield, National Multiple Sclerosis Society, Adio Specific Chiropractic, Optimal Care, Social Security Administration, Parkinson Foundation, The Kreative Health Group, National Capital Poison, Adoptions Together, Sickle Cell Association, Alzheimer's Association, Parkinson Foundation, Kaiser Permanente, Adio Specific Chiropractic, New You Wellness and Fitness, Z&G Et, Prince Georges Sheriff Department, Optimal Care Chiropractic, Greater Baden Medical Services, Physicians Care, Big Brothers and Big Sisters, Tabor Chiropractics, Dr.Harmon-Dentist, ,Daughter for the Day, Katrina Assistance Recovery Effort, PG Department of Social Services, Pharmanex, U.S. Park Police Aviation Unit.


• Vendors may set-up between the hours of 11 – 12:30 cars must be remove from the vendor’s area and parked in the designated area.
• B&K will provide organizations with 1 table and 2 chairs.

Please contact Mr. Bruce Odams, at (202) 556-1772 if you have any questions. We look forward to hearing from you.

I, the undersigned, agree to the terms above:

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