February 17, 2018 – Fairfield, Conneticut This event will now take place on February 17, 2018, at Ingels Family Health, located at 22 Fairfield Place, Fairfield, CT 06824. You are Registering for the Event on:*This event will now take place on February 17, 2018, at Ingels Family Health, located at 22 Fairfield Place, Fairfield, CT 06824. Screening Prices Single Screen Base Rate 2 or more People Rate $195 $175 per person *ALL FIELDS ARE REQUIREDFirst Name*Last Name*Email* Enter Email Confirm Email *How many individuals will you be registering for?*Select One*1 person (myself)2 people (myself +1 family member)3 people (myself +2 family members)4 people (myself +3 family members)5 people (myself +4 family members)6 people (myself +5 family members)How did you hear about the Lyme Screening Event?*Select One*FacebookInstagramInternet SearchFriends/FamilyGlymedx.com WebsiteMy PhysicianIngels Family HealthDr. Jonathan GoodmanOtherOther: Please Specify** Yes - I give glymedx.com (Global Lyme Diagnostics) permission to contact me via email or by phone regarding event registration and information about upcoming events. If you are unable to attend this Lyme Screening event, please click here to provide feedbackCurrent SubmissionsWaitlist This iframe contains the logic required to handle Ajax powered Gravity Forms.