Speaker Request Form
Thank you for your interest in arranging a speaker from Physicians for a National Health Program (PNHP). We have speakers around the country, in numerous specialties, available for in-person and virtual presentations. A select list of speakers and their biographies is here, and an expanded list is here [link to a google view-only sheet with name, location, specialty].

Should you have any questions about arranging a speaker from PNHP, please contact organizer@pnhp.org
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Email *
Your name *
Hosting institution or event sponsor *
Your role at the institution or event *
Event's location (city, state) *
Event's date or prospective dates *
Your phone number *
What type of engagement are you arranging? *
Would you like a speaker who can present in person or virtually? *
What specific topic would you like this presentation to address?  *
Are you requesting a specific speaker? *
If you are requesting a specific speaker, please list:
If you would like a speaker from a specific specialty, please list:
Does this engagement pay honorarium or travel expenses? *
Any additional comments, requirements, information, or requests?
A copy of your responses will be emailed to the address you provided.
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