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Classroom Presentation Request
For classroom presentations about services offered by the Student Health Center, please fill out the information below.
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* Indicates required question
Professor or Faculty Member name
*
Your answer
Email address
*
Your answer
How many students in the class?
Your answer
How long would you like the presentation to be? Complete classroom presentations are usually 20-30 minutes in duration, but can be customized upon request
Your answer
Is this in-person or remote?
*
In-person
Remote
Other:
If in-person, what building and room?
Your answer
Date and time requested #1
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Time
:
AM
PM
Date and time requested #2
MM
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DD
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YYYY
Time
:
AM
PM
Date and time requested #3
MM
/
DD
/
YYYY
Time
:
AM
PM
Anything specific you'd like us to present in addition to our services?
Your answer
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