Millis Regional Health Education Center

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Schedule A Visit

SCHEDULE A VISIT

Scheduling your class for a program at Millis Center is easy. Call 336-878-6713, or fill out the form below and send it to us. We will call you back to discuss such specifics as available dates and times for the program you want, and to confirm your reservation.

Name (required) * (Name (required) is required)

Street Address (required) * (Street Address (required) is required)

City

State

Zip Code

Phone (required) * (Phone (required) is required)

Email Address

Group/School * (Group/School is required)

Grade Level * (Grade Level is required)

Program Desired * (Program Desired is required)

How many students are in your group? * (How many students are in your group? is required)

Lunch - yes or no * (Lunch - yes or no is required)

Are there any students with special needs that we need to be aware of in order to accommodate the group?

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