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Outreach Referral

Please complete the online referral form below and a team member will contact you. You may also call 918-595-4273 during regular business hours to connect with a staff member. Calls received in the evenings or on weekends will be returned the next business day.

Outreach Referral

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Your Name*
Your Address*
Your Email Address*
Please check any/all areas that you would like help with:*
Note: The Tulsa Health Department's car seat installment program is suspended until further notice. Please check back for an update.
How may we contact you?*
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We will take reasonable precautions to prevent the loss, misuse or alteration of your personal information. However, data transmission over the internet is inherently insecure, and we cannot guarantee the security of data sent over the internet. If you do not wish to transmit your information electronically, you can call 918-595-4273 to speak to someone over the phone.
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We have 10 locations across Tulsa County that offer a variety of services to help you and your family stay healthy.

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