Mobile Testing Services Request • PALSS

Bringing Care to Your Community

Would you like us to come into your community? PALSS Mobile Testing Service is dedicated to bringing essential healthcare directly to you. Our team offers free, confidential testing and screening for HIV, STIs, Hepatitis, and COVID-19.

Organization(Required)

Location of Event Needs(Required)

Street Address Address Line 2 City State ZIP Code

Contact Name(Required)

First Last

Contact Email(Required)

Contact Mobile Phone

Contact Office Phone

Date Requested(Required)

Time of Event(Required)

Event Name or Type(Required)

Please describe the event briefly.