PNHP NY-Metro Speaker Request Form
PNHP-NY Metro provides expert speakers to discuss healthcare reform and present evidence that single-payer; the NY Health Act and improved Medicare-for-All, is the solution to our unjust healthcare system. Our speakers can address the merits of a single-payer health care system in New York State and nationally, and can discuss the dangers of the increasing privatization of our public healthcare programs, Medicare and Medicaid.  

Please fill out the form below to request a speaker for an upcoming event, and we will get back to you as soon as possible.  For any questions, please feel free to email morgan@pnhpnymetro.org. 

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Email *
Your Name: *
Organization Name, if applicable:
Phone Number
Will the event be held virtually or in-person?
 *
Will there be a screen/projector set up on which a presentation can be shared? *
Event Date *
MM
/
DD
/
YYYY
Event Time (if it is a long event, please the share time at which the speaker will be needed) *
Event location: Please include address and name of hosting institution (if applicable). *
Borough/Town in which event will take place. *
Requests for specific topics?  Please let us know if there are primary subjects you would like us to cover, i.e. New York Health Act, racism in healthcare, labor/unions, etc.
Are there other organizations cosponsoring the event? Please share, if known.
Briefly describe the type of event (Panel discussion, solo presentation, Grand Rounds, rally etc)
Anything else you'd like us to know about your event
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