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Healthy Celebration Member RSVP

Healthy Celebration Member RSVP

Managed Health Services (MHS) cares about you and your family. You or your child is due for a checkup. Join us for a Healthy Celebration event where you or your child can get this checkup or screening. After your appointment, you can earn a $25 gift card.

To RSVP for a Healthy Celebration, please fill out the information below.

Date of the Healthy Celebration you would like to attend: *

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Time of the Healthy Celebration you would like to attend *

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Address of the Healthy Celebration you would like to attend *

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What is the name and address of the clinic that you usually go to for checkups? Please include Clinic Name and Clinic Address: *

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For each MHS member in your household, please enter their name, date of birth, Medicaid ID number, and if it has been at least one year since their last checkup.

Name *

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Date of Birth *

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Medicaid ID Number

Has it been at least one year since their last checkup visit? required * Yes No

Error: This field is required.

Name

Date of Birth

Medicaid ID Number

Has it been at least one year since their last checkup visit? Yes No

Error: This field is required.

Name

Date of Birth

Medicaid ID Number

Has it been at least one year since their last checkup visit? Yes No

Error: This field is required.

Name

Date of Birth

Medicaid ID Number

Has it been at least one year since their last checkup visit? Yes No

Error: This field is required.

Name

Date of Birth

Medicaid ID Number

Has it been at least one year since their last checkup visit? Yes No

Error: This field is required.

What is the best phone number to reach you at? *

Error: This field is required.

Additional Comments

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THIS EVENT IS FOR MHS MEMBERS ONLY.

Last Updated: 06/04/2026

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Need information in a different language or format? MHS will provide it at no cost to you. Call 1-877-647-4848 (TTY: 1-800-743-3333).

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Need information in a different language or format? MHS will provide it at no cost to you. Call 1-877-647-4848 (TTY: 1-800-743-3333).

You will need Adobe Reader to open PDFs on this site. Download the free version of Adobe Reader.

1-877-647-4848 (TTY: 1-800-743-3333)

Need information in a different language or format? MHS will provide it at no cost to you. Call 1-877-647-4848 (TTY: 1-800-743-3333).

You will need Adobe Reader to open PDFs on this site. Download the free version of Adobe Reader.

Need information in a different language or format? MHS will provide it at no cost to you. Call 1-877-647-4848 (TTY: 1-800-743-3333).

You will need Adobe Reader to open PDFs on this site. Download the free version of Adobe Reader.

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