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EHRtoday Speaker’s Bureau Application

Thank you for offering your time as a speaker on issues of Electronic Health Records Security and Privacy. The HISPC Collaborative is working hard to help providers and consumers understand and manage these issues successfully so that we can all enjoy the many benefits of Electronic Health Records.

Please fill out the following short form and e-mail it to our Public Relations Management Team. Please note that by signing this form, you are allowing us to use your name and the title or topic of your talk for promoting speaker availability to various provider and consumer groups. Thank you again!

If you have any questions regarding this information, or would like to contact us, please call Lisa Stansbury, Louisiana Health Care Review, at (225)248-7023 (direct line), or e-mail her at lstansbury@lhcr.org.

Name:
Title:
Organization:
Physical Address:
Email Address:
Topic(s):
Audio/visual equipment needs:
Preferred dates and times for speaking engagements:
Geographic preference:
Short Bio (2 paragraphs):
Optional photo (.jpg only please):