Requesting the Ronald McDonald Care Mobile

Complete the following form and a member of the Ronald McDonald Care Mobile team will contact you regarding scheduling.

Please note requests should be submitted at least 30 days in advance from the date requested.

The 40-foot care mobile unit is staffed by Parkview Physicians Group – Pediatrics providers and is complete with two patient exam rooms, a laboratory and a patient education center. Service area includes Allen, Huntington, Kosciusko, LaGrange, Noble, Wabash and Whitley counties.

 
Name of Business/Organization  *Address  *City  *State  *Contact Person  *Contact Phone Number  *Contact Email Address  *Date Requested  *Start Time Requested  *End Time Requested  *Summary of Event  *