WorkWell NYC

Request a Worksite Know Your Numbers Clinic

Thank you for your interest in WorkWell NYC's worksite Know Your Numbers clinics.

Please complete the form below and we will contact you to complete the scheduling of your clinic within one week.

    Agency and Location Information

    Note: If you are requesting services at multiple locations, please complete a form for each location

    Main Contact Information
    Back-up Contact Information
    Event Information
    Room Selection

    Note: Each nurse requires one table, 2 chairs, access to an outlet and a wastebasket (for non-medical wastes). Our nurses will arrive 30 minutes before the event start time to set up.

    Other